Strategies for reducing coronary risk factors in primary care: which is most cost effective?
Objective: To examine the relative cost effectiveness of a range of screening and intervention strategies for preventing coronary heart disease in primary care. Subjects: 7840 patients aged 35-64 years who were participants in a trial of modifying coronary heart disease risk factors in primary care. Design: Effectiveness of interventions assumed and the potential years of life gained estimated from a risk equation calculated from Framingham study data. Main outcome measure: The cost per year of life gained. Results: The most cost effective strategy was minimal screening of blood pressure and personal history of vascular disease, which cost pounds sterling310-pounds sterling930 per year of life gained for men and pounds sterling1100-pounds sterling3460 for women excluding treatment of raised blood pressure. The extra cost per life year gained by adding smoking history to the screening was pounds sterling400-pounds sterling6300 in men. All strategies were more cost effective in men than
