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The cost-effectiveness of the SPHERE intervention for the secondary prevention of coronary heart disease

Published online by Cambridge University Press:  29 June 2010

Paddy Gillespie ,
Eamon O'Shea ,
Andrew W. Murphy ,
Mary C. Byrne ,
Molly Byrne ,
Susan M. Smith  and
Margaret E. Cupples
Paddy Gillespie
Affiliation:
National University of Ireland, Galway
Eamon O'Shea
Affiliation:
National University of Ireland, Galway
Andrew W. Murphy
Affiliation:
National University of Ireland, Galway
Mary C. Byrne
Affiliation:
National University of Ireland, Galway
Molly Byrne
Affiliation:
National University of Ireland, Galway
Susan M. Smith
Affiliation:
Trinity College Dublin
Margaret E. Cupples
Affiliation:
Queen's University Belfast
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Abstract

Objectives: The Secondary Prevention of Heart disEase in geneRal practicE (SPHERE) trial has recently reported. This study examines the cost-effectiveness of the SPHERE intervention in both healthcare systems on the island of Ireland.

Methods: Incremental cost-effectiveness analysis. A probabilistic model was developed to combine within-trial and beyond-trial impacts of treatment to estimate the lifetime costs and benefits of two secondary prevention strategies: Intervention - tailored practice and patient care plans; and Control - standardized usual care.

Results: The intervention strategy resulted in mean cost savings per patient of €512.77 (95 percent confidence interval [CI], −1086.46–91.98) and an increase in mean quality-adjusted life-years (QALYs) per patient of 0.0051 (95 percent CI, −0.0101–0.0200), when compared with the control strategy. The probability of the intervention being cost-effective was 94 percent if decision makers are willing to pay €45,000 per additional QALY.

Conclusions: Decision makers in both settings must determine whether the level of evidence presented is sufficient to justify the adoption of the SPHERE intervention in clinical practice.

Keywords

Coronary heart diseaseSecondary preventionGeneral practiceCost-effectiveness analysis
Type
ASSESSMENTS
Information
International Journal of Technology Assessment in Health Care , Volume 26 , Issue 3 , July 2010 , pp. 263 - 271
Copyright
Copyright © Cambridge University Press 2010

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