title: A cost-benefit analysis of lipid standardization in the United States.
abstract: BACKGROUND
  By improving lipid standardization, the Centers for Disease Control and Prevention's (CDC's) Lipid Standardization Program and Cholesterol Reference Method Laboratory Network have contributed to the marked reduction in heart disease deaths since 1980. The objective of this study was to estimate the benefits (ie, the value of reductions in heart disease deaths) and costs attributable to these lipid standardization programs.
  
  
  METHODS
  We developed a logic model that shows how the inputs and activities of the lipid standardization programs produce short- and medium-term outcomes that in turn lead to improvements in rates of cardiovascular disease and death. To calculate improvements in long-term outcomes, we applied previous estimates of the change in heart disease deaths between 1980 and 2000 that was attributable to statin treatment and to the reduction in total cholesterol during the period. Experts estimated the share of cholesterol reduction that could be attributed to lipid standardization. We applied alternative assumptions about the value of a life-year saved to estimate the value of life-years saved attributable to the programs.
  
  
  RESULTS
  Assuming that 5% of the cholesterol-related benefits were attributable to the programs and a $113,000 value per life-year, the annual benefit attributable to the programs was $7.6 billion. With more conservative assumptions (0.5% of cholesterol-related benefits attributable to the programs and a $50,000 value per life-year), the benefit attributable to the programs was $338 million. In 2007, the CDC lipid standardization programs cost $1.7 million.
  
  
  CONCLUSIONS
  Our estimates suggest that the benefits of CDC's lipid standardization programs greatly exceed their costs.
authors: RTI International, 3040 Cornwallis Road, PO Box 12194, Research Triangle Park, NC 27709, USA. tjh@rti.org
authors: Thomas J
authors: TJ
authors: Hoerger
authors: John S
authors: JS
authors: Wittenborn
authors: Walter
authors: W
authors: Young
mesh_terms: D002318:Cardiovascular Diseases / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D002423:Cause of Death / Q000639:trends; D003362:Cost-Benefit Analysis; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D008055:Lipids / Q000097:blood / Q000592:standards*; D016015:Logistic Models; D008875:Middle Aged; D015397:Program Evaluation; D019057:Quality-Adjusted Life Years; D012015:Reference Standards; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids