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Which interventions offer best value for money in primary prevention of cardiovascular disease?

Cobiac, Linda J., Magnus, Anne, Lim, Stephen, Barendregt, Jan, Carter, Rob and Vos, Theo 2012, Which interventions offer best value for money in primary prevention of cardiovascular disease?, PLoS ONE, vol. 7, no. 7, Article number e41842, pp. 1-19.

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Title Which interventions offer best value for money in primary prevention of cardiovascular disease?
Author(s) Cobiac, Linda J.
Magnus, Anne
Lim, Stephen
Barendregt, Jan
Carter, Rob
Vos, Theo
Journal name PLoS ONE
Volume number 7
Issue number 7
Season Article number e41842
Start page 1
End page 19
Total pages 19
Publisher Public Library of Science
Place of publication San Francisco, Calif.
Publication date 2012-07-23
ISSN 1932-6203
Keyword(s) cardiovascular disease
interventions
Summary Background
Despite many decades of declining mortality rates in the Western world, cardiovascular disease remains the leading cause of death worldwide. In this research we evaluate the optimal mix of lifestyle, pharmaceutical and population-wide interventions for primary prevention of cardiovascular disease.

Methods and Findings

In a discrete time Markov model we simulate the ischaemic heart disease and stroke outcomes and cost impacts of intervention over the lifetime of all Australian men and women, aged 35 to 84 years, who have never experienced a heart disease or stroke event. Best value for money is achieved by mandating moderate limits on salt in the manufacture of bread, margarine and cereal. A combination of diuretic, calcium channel blocker, ACE inhibitor and low-cost statin, for everyone with at least 5% five-year risk of cardiovascular disease, is also cost-effective, but lifestyle interventions aiming to change risky dietary and exercise behaviours are extremely poor value for money and have little population health benefit.

Conclusions
There is huge potential for improving efficiency in cardiovascular disease prevention in Australia. A tougher approach from Government to mandating limits on salt in processed foods and reducing excessive statin prices, and a shift away from lifestyle counselling to more efficient absolute risk-based prescription of preventive drugs, could cut health care costs while improving population health.


Notes This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Language eng
Field of Research 140208 Health Economics
Socio Economic Objective 920412 Preventive Medicine
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2012, Cobiac et al.
Persistent URL http://hdl.handle.net/10536/DRO/DU:30046546

Document type: Journal Article
Collections: Population Health
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Created: Thu, 02 Aug 2012, 11:48:36 EST by Jane Moschetti

Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.