Openly accessible

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, pp. 1-10, doi: 10.1371/journal.pone.0041842.

Attached Files
Name Description MIMEType Size Downloads
magnus-whichinterventions-2012.pdf Published version application/pdf 423.94KB 283

Title Which interventions offer best value for money in primary prevention of cardiovascular disease?
Author(s) Cobiac, Linda J.
Magnus, AnneORCID iD for Magnus, Anne orcid.org/0000-0002-1165-8161
Lim, Stephen
Barendregt, Jan
Carter, RobORCID iD for Carter, Rob orcid.org/0000-0002-1586-5619
Vos, Theo
Journal name PLoS One
Volume number 7
Issue number 7
Article ID e41842
Start page 1
End page 10
Total pages 10
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.
Language eng
DOI 10.1371/journal.pone.0041842
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.
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30046546

Document type: Journal Article
Collections: Population Health
Open Access Collection
Connect to link resolver
 
Unless expressly stated otherwise, the copyright for items in DRO is owned by the author, with all rights reserved.

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.

Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 42 times in TR Web of Science
Scopus Citation Count Cited 43 times in Scopus
Google Scholar Search Google Scholar
Access Statistics: 385 Abstract Views, 283 File Downloads  -  Detailed Statistics
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.