| Titre : | Health and economic benefits of increased bêta-blocker use following myocardial infarction. (2000) |
| Auteurs : | Kathryn-A PHILLIPS ; P.A.M. COXSON ; Paula-A GOLDMAN ; L.E.E. GOLDMAN ; Paul-A HEIDENREICH ; Mcmyriam HUNINK ; Michael-G SHLIPAK ; Milton-C WEINSTEIN ; Lawrence-W Williams ; Department of Health Policy and Management. Harvard School of Public Health. Boston Mass. NLD ; Department of Medicine. University of Californi. San Francisco. USA |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (vol. 284, n° 21, 2000) |
| Pagination : | 2748-2754 |
| Langues: | Anglais |
| Mots-clés : | Infarctus ; Myocarde ; Thérapeutique médicamenteuse ; Thérapeutique ; Homme ; Economie santé ; Appareil circulatoire [pathologie] ; Cardiopathie coronaire ; Myocarde [pathologie] |
| Résumé : | [BDSP. Notice produite par INIST yR0x9EeR. Diffusion soumise à autorisation]. Context bêta-Blockers are underused in patients who have myocardial infarction (MI), despite the proven efficacy of these agents. New evidence indicates that bêta-blockers can have benefit in patients with conditions that have been considered relative contraindications. Understanding the consequences of underuse of bêta-blockers is important because of the implications for current policy debates over quality-of-care measures and Medicare prescription drug coverage. Objective To examine the potential health and economic impact of increased use of bêta-blockers in patients who have had Ml. Design and Setting We used the Coronary Heart Disease (CHD) Policy Model, a computer-simulation Markov model of CHD in the US population, to estimate the epidemiological impact and cost-effectiveness of increased bêta-blocker use from current to target levels among survivors of Ml aged 35 to 84 years. Simulations included 1 cohort of Ml survivors in 2000 followed up for 20 years and 20 successive annual cohorts of all first-MI survivors in 2000-2020. Mortality and morbidity from CHD were derived from published meta-analyses and recent studies. This analysis used a societal perspective. Main Outcome Measures Prevented MIs, CHD mortality, life-years gained, and cost per quality-adjusted life-year (QALY) gained in 2000-2020. (...) |
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