title: Cost-effectiveness of Maintaining Daily Intake of Oat β-Glucan for Coronary Heart Disease Primary Prevention.
abstract: OBJECTIVE
  Oat β-glucan reduces cholesterol levels and thus reduces the risk for coronary heart disease (CHD). However, its economic impact has not been well studied. We examined the economic impact of daily intake of ≥3 g of oat β-glucan in primary prevention of CHD in patients receiving statins or no pharmacologic treatment.
  
  
  METHODS
  A decision model was developed to compare costs and outcomes associated with lowering cholesterol levels with no pharmacologic treatment and normal diet, no pharmacologic treatment plus ≥3 g/d of oat β-glucan, and statin therapy plus ≥3 g/d of oat β-glucan. The population comprised men 45, 55, or 65 years of age with no history of cardiovascular disease and a 10-year risk for CHD of 5%, 7.5%, or 10%. Clinical efficacy data were gathered from meta-analyses; safety data, costs, and utilities were gathered from published literature. Cost per quality-adjusted life years and number of first events were reported.
  
  
  RESULTS
  Maintaining ≥3 g/d of β-glucan may be cost-effective in men aged 45, 55, and 65 years with 10-year CHD risks of 5.0%, 7.5%, and 10.0% taking no pharmacologic treatment or on statins. It may also reduce first events of myocardial infarction and CHD death. Results are sensitive to oat β-glucan cost but insensitive to changes in other parameters. Maintaining ≥3 g of oat β-glucan daily remains cost-effective within plausible range of values.
  
  
  CONCLUSIONS
  β-glucan may be cost-effective for preventing CHD events in middle-aged men with no history of cardiovascular events whose 10-year CHD risk is ≥5%. Maintaining daily β-glucan intake may have considerable impact on first events.
authors.affiliation: RTI Health Solutions, Research Triangle Park, North Carolina. Electronic address: searnshaw@rti.org.
authors.forename: Stephanie R
authors.initials: SR
authors.lastname: Earnshaw
authors.affiliation: RTI Health Solutions, Research Triangle Park, North Carolina.
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: McDade
authors.affiliation: PepsiCo, Inc, Chicago, Illinois.
authors.forename: YiFang
authors.initials: Y
authors.lastname: Chu
authors.affiliation: PepsiCo, Inc, Chicago, Illinois.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Fleige
authors.affiliation: Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada; Division of Endocrinology & Metabolism, St. Michael's Hospital, Toronto, Ontario, Canada; Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification Centre, St. Michael's Hospital; Li Ka Shing Knowledge Institute, St. Michael's Hospital.
authors.forename: John L
authors.initials: JL
authors.lastname: Sievenpiper
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000191:economics* / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000191:economics; D019057:Quality-Adjusted Life Years; D047071:beta-Glucans / Q000191:economics* / Q000627:therapeutic use*
chemical_list: D047071:beta-Glucans; C067858:beta-glucan, (1-3)(1-4)-
keywords: cholesterol; coronary heart disease; cost-effectiveness; fiber; primary prevention; β-glucan