Van Gool & Bridges
They estimated a cost-effectiveness ratio in the order of US$5,000 -US$10,000 (1975
dollars) per quality adjusted life year (QALY). The lower bound accounted for
moderate to severe hypertension while the upper bound was for the treatment of mild
hypertension.
The cost-effectiveness of a screening program together with an optimal treatment
program was also estimated. This gave a cost of US$6,600 (1975 dollars) per QALY
saved. Even lower costs were estimated if such a screening program was aimed at the
black population.
It can be concluded from this study that a screening and treatment program would be
more cost effective if delivered through normal medical channels, rather than through
specialised clinics. This conclusion is supported by the findings from Christinson et al
(1981).
Weinstein and Stason (1985) also considered two preventive treatments in the detection
and treatment Ofhypercholesterolemia; dietary interventions and cholesterol lowering
drugs. They noted that the cost-effectiveness of paediatric screening and dietary
intervention programs for hypercholesterolemia returned a cost per life year gained of
US$93,000 for females and US$10,700 for males (measured in 1975 dollars). The costs
of these fell if screening programs were targeted at people with a family history of
CHD.
Medical treatment Ofhypercholesterolemia yielded a cost of US$126,000 (1975) per life
year saved. Even though this points to poor cost-effectiveness of pharmacological
interventions, the validity of using such evidence today is questionable because of the
development of new cholesterol lowering agents.
In summary, Weinstein and Stason (1985) stated that the cost-effectiveness of the
different measures in their study provides a yardstick that can be used to direct future
resources to a more efficient use.
One of the lessons to be learned from the Weinstein and Stason (1985) paper is that if
one is going to compare different cost-effectiveness figures one has to be certain that
Chere Project Report 11- November 1999
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