Oster G, Epstein A M
Am J Public Health. 1986 Jun;76(6):647-56. doi: 10.2105/ajph.76.6.647.
We examined the expected economic benefits of cholesterol lowering for adult men with significant elevations of total serum cholesterol (above 260 mg/dl), incorporating estimates of direct benefits from anticipated reductions in lifetime expenditures for medical care, and estimates of indirect benefits related to extension of work-life secondary to reductions in morbidity and premature mortality. Our findings yield discounted lifetime direct benefits of a 15 per cent reduction in total serum cholesterol of $3 to $208 per person, and discounted lifetime indirect benefits of $1 to $8,946. Benefits increase with an individual's initial cholesterol level and decrease with the age at which an intervention is initiated. Economic benefits increase approximately twofold in the presence of other coronary risk factors, such as cigarette smoking and hypertension. Results suggest that cholesterol-lowering interventions, no matter what their cost, are unlikely to result in substantial direct savings to the health care system. However, the indirect benefits of intervention are quite high for young and middle-aged adults, as well as for those with severe elevations of cholesterol or with additional coronary risk factors.
我们研究了降低胆固醇对血清总胆固醇显著升高（高于260毫克/分升）的成年男性的预期经济效益，其中纳入了预期医疗保健终身支出减少带来的直接效益估计，以及因发病率和过早死亡率降低而延长工作寿命相关的间接效益估计。我们的研究结果表明，血清总胆固醇降低15%带来的贴现终身直接效益为每人3美元至208美元，贴现终身间接效益为1美元至8946美元。效益随个体初始胆固醇水平的升高而增加，随干预开始时的年龄增长而降低。在存在其他冠状动脉危险因素（如吸烟和高血压）的情况下，经济效益大约会增加一倍。结果表明，无论成本如何，降低胆固醇的干预措施不太可能为医疗保健系统带来可观的直接节省。然而，对于年轻人和中年人，以及胆固醇严重升高或有其他冠状动脉危险因素的人来说，干预的间接效益相当高。
