title: Cost effectiveness of treatments for non-ST-segment elevation acute coronary syndrome.
abstract: BACKGROUND
  Acute coronary syndrome (ACS) represents the most common subset of cardiovascular heart diseases and relates to high rates of morbidity and mortality worldwide and, consequently, to both the direct and indirect costs to the health system and society. Given the rising healthcare costs combined with budgetary constraints, health care systems and decision makers are faced with challenging decisions and the need to choose alternative treatments that not only improve patient quantity and quality of life but are also economically attractive.
  
  
  OBJECTIVE
  To systematically review the published literature and to identify studies evaluating the cost effectiveness of different treatments for patients presenting with non-ST-segment elevation (NSTE) ACS.
  
  
  METHODS
  A literature search was performed using PubMed and the Cochrane Library until October 2013, with no limit on publication date.
  
  
  METHODS
  The search was conducted using predetermined inclusion and exclusion criteria, limiting articles to those published in the English language and those reporting results of economic evaluations [i.e. cost-effectiveness (CEA), cost-utility (CUA) cost-minimisation (CMA) cost-consequence (CCA) and cost-benefit (CBA) analyses] of the different treatment therapies used for managing patients presenting with NSTE-ACS. Publications such as editorials, letters to the editor, posters, expert opinions, reviews, systematic reviews, or meta-analyses were excluded.
  
  
  METHODS
  All studies included were assessed for their methodological quality using the British Medical Journal checklist.
  
  
  RESULTS
  A total of 39 studies were included, presenting a wide variation in terms of methodological approaches and settings, thus resulting in different ranges of incremental cost-effectiveness ratios for each treatment evaluated.
  
  
  CONCLUSIONS
  Evidence from the present systematic review suggests that the majority of the available treatments represent either cost-saving or cost-effective options for NSTE-ACS patients. Moreover, the cost effectiveness of the available treatments was found to be dependent on various factors, particularly the risk profile of patients and the cost of treatment, and hence there is a need to take these into consideration when making decisions and choices.
authors.affiliation: Department of Health Services Organization and Management, National School of Public Health, 196 Alexandras Avenue, 115 21, Athens, Greece.
authors.forename: Fotini
authors.initials: F
authors.lastname: Gialama
authors.forename: Evangelia
authors.initials: E
authors.lastname: Miloni
authors.forename: Nikos
authors.initials: N
authors.lastname: Maniadakis
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy / Q000191:economics*; D000925:Anticoagulants / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D017048:Health Care Costs; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000191:economics* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors
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