Nicholson Gina, Gandra Shravanthi R, Halbert Ronald J, Richhariya Akshara, Nordyke Robert J
ICON, El Segundo.
Amgen Inc., Thousand Oaks, CA, USA.
Clinicoecon Outcomes Res. 2016 Sep 21;8:495-506. doi: 10.2147/CEOR.S89331. eCollection 2016.
Robust cost estimates of cardiovascular (CV) events are required for assessing health care interventions aimed at reducing the economic burden of major adverse CV events. This review synthesizes international cost estimates of CV events.
MEDLINE database was searched electronically for English language studies published during 2007-2012, with cost estimates for CV events of interest - unstable angina, myocardial infarction, heart failure, stroke, and CV revascularization. Included studies provided at least one estimate of patient-level direct costs in adults for any identified country. Information on study characteristics and cost estimates were collected. All costs were adjusted for inflation to 2013 values.
Across the 114 studies included, the average cost was US $6,466 for unstable angina, $11,664 for acute myocardial infarction, $11,686 for acute heart failure, $11,635 for acute ischemic stroke, $37,611 for coronary artery bypass graft, and $13,501 for percutaneous coronary intervention. The ranges for cost estimates varied widely across countries with US cost estimate being at least twice as high as European Union costs for some conditions. Few studies were found on populations outside the US and European Union.
This review showed wide variation in the cost of CV events within and across countries, while showcasing the continuing economic burden of CV disease. The variability in costs was primarily attributable to differences in study population, costing methodologies, and reporting differences. Reliable cost estimates for assessing economic value of interventions in CV disease are needed.
为评估旨在减轻主要不良心血管事件经济负担的医疗保健干预措施，需要对心血管（CV）事件进行可靠的成本估算。本综述综合了CV事件的国际成本估算。
通过电子方式检索MEDLINE数据库，查找2007年至2012年期间发表的英文研究，这些研究包含对感兴趣的CV事件——不稳定型心绞痛、心肌梗死、心力衰竭、中风和CV血运重建的成本估算。纳入的研究提供了至少一项针对任何已识别国家中成人患者层面直接成本的估算。收集了有关研究特征和成本估算的信息。所有成本均根据通货膨胀调整至2013年的价值。
在纳入的114项研究中，不稳定型心绞痛的平均成本为6466美元，急性心肌梗死为11664美元，急性心力衰竭为11686美元，急性缺血性中风为11635美元，冠状动脉搭桥术为37611美元，经皮冠状动脉介入治疗为13501美元。不同国家的成本估算范围差异很大，在某些情况下，美国的成本估算至少是欧盟成本的两倍。在美国和欧盟以外的人群中发现的研究很少。
本综述表明，各国国内和各国之间CV事件的成本差异很大，同时展示了CV疾病持续的经济负担。成本差异主要归因于研究人群、成本核算方法和报告差异。需要可靠的成本估算来评估CV疾病干预措施的经济价值。
