Nutrition and Coronary Heart Disease
TABLE 9 COST-EFFECTIVENESS RATIOS
|
INTERVENTION |
GP |
COMMUNITY |
MASS |
HOSPITAL |
|
Population |
300,000 |
253,000 |
400,000 |
4~800~ |
|
Total Cost (pa) |
5,936,000 |
1,451,000 |
500,000 |
468,000 |
|
Reduction in Risk (approx) |
14% |
6% |
4% |
25% |
|
Years OfEffectiveness |
5.5 |
3.5 |
2 |
3.5 |
|
Deaths Prevented* |
135 |
48 |
22 |
20 |
|
CEA Ratio |
$43,873 |
_________$30,151 |
$22,727 |
$23,054 |
*Note rounding
The CEA ratio should be interpreted as the cost per CHD deaths prevented. That is,
given the costs, effectiveness, length of intervention and existing CHD death rates, the
CEA ratio provides a dollar measurement for every CHD death prevented. The ranking
of interventions, in order of most favourable to least favourable CEA ratio, are (1) Mass
Media, (2) HospitalZRehab, (3) Community and (4) GP.
Sensitivity Analysis - Length of effectiveness
A sensitivity analysis is a crucial part of any cost-effectiveness exercise. This part of the
analysis aims to alter some of the underlying assumptions made and test the robustness
of the results. As highlighted above, one of the main assumptions in this analysis is the
length of effectiveness of any intervention.
The following table shows the CEA ratio for each intervention according to the
minimum, maximum and mid point years of effectiveness (see table 4).
TABLE 10: SENSITIVITY ANALYSIS: CEA RATIOS ACCORDING TO YEARS OF
EFFECTIVENESS
|
INTERVENTION |
CEA RATIO WITH CEA RATIO CEA RATIO WITH MINIMUM AT MAXIMUM EFFECTIVENESS MID-POINT EFFECTIVENESS |
|
GP Based |
$60,448 $43,873 $34,541 $53,346 $30,151 $21,338 $45,455 $22,727 $15,152 ______________$40,345_________________$23,054______________$16,138 |
Table 10 shows how the CEA ratio ranking changes if the years of effectiveness are
varied.
CHERE Project Report 11- November 1999
30
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