Cost-effectiveness of risk assessment and tailored treatment for peripheral arterial disease patients

被引：0
作者：
Vaidya, Anil [1 ,2 ]
Joore, Manuela A. [1 ,2 ]
ten Cate-Hoek, Arina J. [3 ]
ten Cate, Hugo [3 ]
Severens, Johan L. [4 ]
机构：
[1] Maastricht Univ, Med Ctr, Dept Clin Epidemiol & Med Technol Assessment KEMT, NL-6202 AZ Maastricht, Netherlands
[2] Maastricht Univ, Sch Publ Hlth & Primary Care CAPHRI, NL-6202 AZ Maastricht, Netherlands
[3] Maastricht Univ, Med Ctr, Cardiovasc Res Inst Maastricht, Lab Clin Thrombosis & Haemostasis,Dept Internal M, NL-6202 AZ Maastricht, Netherlands
[4] Erasmus Univ, Inst Hlth Policy & Management, Rotterdam, Netherlands
来源：
BIOMARKERS IN MEDICINE | 2014年 / 8卷 / 08期
关键词：
cost-effectiveness analysis; D-dimer; decision modeling; peripheral arterial disease; risk assessment; ORAL ANTICOAGULANTS; EVENT RATES;
D O I：
10.2217/BMM.14.45
中图分类号：
R-3 [医学研究方法]; R3 [基础医学];
学科分类号：
1001 ;
摘要：
Aim: The objective of this study was to explore the cost-effectiveness of D-dimer biomarker and the societal value (headroom) of a hypothetical perfect biomarker for risk assessment and subsequent treatment stratification of prophylactic treatment for peripheral arterial disease (PAD). Patients & methods: Decision analytic modeling. Results: Use of the D-dimer biomarker to prescribe oral anticoagulants in the high-risk subset of patients is a cost-effective healthcare intervention. The headroom (societal willingness to pay multiplied by incremental quality-adjusted life years) available for the hypothetical perfect biomarker amounted to (sic)83,877. Conclusion: D-dimer-based PAD risk assessment and treatment tailoring is cost effective. Identification of high-risk PAD patients and prescription of oral anticoagulants could potentially save substantial costs and improve chances of survival for high-risk PAD patients. However, further research of risk stratifying biomarkers test accuracy is needed to support and strengthen the results of this modeling study.
引用
收藏
页码：989 / 999
页数：11
相关论文
共 29 条
  • [1] Three-year follow-up and event rates in the international REduction of Atherothrombosis for Continued Health Registry
    Alberts, Mark J.
    Bhatt, Deepak L.
    Mas, Jean-Louis
    Ohman, E. Magnus
    Hirsch, Alan T.
    Roether, Joachim
    Salette, Genevieve
    Goto, Shinya
    Smith, Sidney C., Jr.
    Liau, Chiau-Suong
    Wilson, Peter W. F.
    Steg, Ph. Gabriel
    [J]. EUROPEAN HEART JOURNAL, 2009, 30 (19) : 2318 - 2326
  • [2] Antithrombotic Therapy in Peripheral Artery Disease Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines
    Alonso-Coello, Pablo
    Bellmunt, Sergi
    McGorrian, Catherine
    Anand, Sonia S.
    Guzman, Randolph
    Criqui, Michael H.
    Akl, Elie A.
    Vandvik, Per Olav
    Lansberg, Maarten G.
    Guyatt, Gordon H.
    Spencer, Frederick A.
    [J]. CHEST, 2012, 141 (02) : E669S - E690S
  • [3] Oral anticoagulants in patients with coronary artery disease: an inexpensive and effective strategy
    Anand, SS
    [J]. THROMBOSIS RESEARCH, 2003, 109 (04) : 159 - 161
  • [4] Baigent C, 2002, BMJ-BRIT MED J, V324, P71, DOI 10.1136/bmj.324.7329.71
  • [5] Berry E, 2002, Health Technol Assess, V6, P1
  • [6] Quantification of the Potential Impact of Cost-effectiveness Thresholds on Dutch Drug Expenditures Using Retrospective Analysis
    Boersma, Cornelis
    Broere, Adriaan
    Postma, Maarten J.
    [J]. VALUE IN HEALTH, 2010, 13 (06) : 853 - 856
  • [7] MORTALITY OVER A PERIOD OF 10 YEARS IN PATIENTS WITH PERIPHERAL ARTERIAL-DISEASE
    CRIQUI, MH
    LANGER, RD
    FRONEK, A
    FEIGELSON, HS
    KLAUBER, MR
    MCCANN, TJ
    BROWNER, D
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1992, 326 (06) : 381 - 386
  • [8] Transferability of Economic Evaluations Across Jurisdictions: ISPOR Good Research Practices Task Force Report
    Drummond, Michael
    Barbieri, Marco
    Cook, John
    Glick, Henry A.
    Lis, Joanna
    Malik, Farzana
    Reed, Shelby D.
    Rutten, Frans
    Sculpher, Mark
    Severens, Johan
    [J]. VALUE IN HEALTH, 2009, 12 (04) : 409 - 418
  • [9] A guide to cost-effectiveness acceptability curves
    Fenwick, E
    Byford, S
    [J]. BRITISH JOURNAL OF PSYCHIATRY, 2005, 187 : 106 - 108
  • [10] Antithrombotic treatment for peripheral arterial disease
    Hackam, Daniel G.
    Eikelboom, John W.
    [J]. HEART, 2007, 93 (03) : 303 - 308
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