Wendland G, Klever-Deichert G, Lauterbach K
Institut für Gesundheitsökonomie und klinische Epidemiologie Gleueler Str. 176-178 50933 Köln, Germany.
Z Kardiol. 2002;91 Suppl 2:49-60.
Most experts agree that prevention of coronary heart disease (CHD) should be enforced. However doubt remains about how extensively pharmacological treatment should be applied. In the presence of strong financial constraints both issues emphasize the importance of health economic analyses in this area. This article describes important principles in health economics. As the effect of preventive measures can only be recognized after a considerable time lag, a long-term perspective has to be chosen. A suitable parameter are the costs per life year saved, which can be compared between otherwise completely different procedures. The assessment of different therapies depends strongly on parameters such as relative risk reduction, discount rate and costs for prevention. However it was shown that prevention with statins and anti-hypertensive therapy can be cost-effective, as the mortality reduction and hence the increase in life expectancy can be considerable. Further research is necessary, e.g., to investigate possible reductions of other vascular diseases, to acquire more knowledge about long-term cost-consequences.
大多数专家都认为应该加强冠心病（CHD）的预防。然而，对于药物治疗应在多大范围内应用仍存在疑问。在资金严重受限的情况下，这两个问题都凸显了该领域健康经济学分析的重要性。本文介绍了健康经济学的重要原则。由于预防措施的效果只能在相当长的时间滞后之后才能显现，因此必须选择长期视角。一个合适的参数是每挽救一个生命年的成本，这可以在其他方面完全不同的程序之间进行比较。对不同疗法的评估在很大程度上取决于相对风险降低、贴现率和预防成本等参数。然而，研究表明，使用他汀类药物进行预防和抗高血压治疗可能具有成本效益，因为死亡率的降低以及预期寿命的增加可能相当可观。还需要进一步的研究，例如，调查其他血管疾病可能的减少情况，以获取更多关于长期成本后果的知识。
