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Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK

OBJECTIVES: To characterise the costs to the UK National Health Service of cardiovascular (CV) events among individuals receiving lipid-modifying therapy. DESIGN: Retrospective cohort study using Clinical Practice Research Datalink records from 2006 to 2012 to identify individuals with their first a...

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Autores principales: Danese, Mark D, Gleeson, Michelle, Kutikova, Lucie, Griffiths, Robert I, Azough, Ali, Khunti, Kamlesh, Seshasai, Sreenivasa Rao Kondapally, Ray, Kausik K
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985970/
https://www.ncbi.nlm.nih.gov/pubmed/27496237
http://dx.doi.org/10.1136/bmjopen-2016-011805
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author Danese, Mark D
Gleeson, Michelle
Kutikova, Lucie
Griffiths, Robert I
Azough, Ali
Khunti, Kamlesh
Seshasai, Sreenivasa Rao Kondapally
Ray, Kausik K
author_facet Danese, Mark D
Gleeson, Michelle
Kutikova, Lucie
Griffiths, Robert I
Azough, Ali
Khunti, Kamlesh
Seshasai, Sreenivasa Rao Kondapally
Ray, Kausik K
author_sort Danese, Mark D
collection PubMed
description OBJECTIVES: To characterise the costs to the UK National Health Service of cardiovascular (CV) events among individuals receiving lipid-modifying therapy. DESIGN: Retrospective cohort study using Clinical Practice Research Datalink records from 2006 to 2012 to identify individuals with their first and second CV-related hospitalisations (first event and second event cohorts). Within-person differences were used to estimate CV-related outcomes. SETTING: Patients in the UK who had their first CV event between January 2006 and March 2012. PARTICIPANTS: Patients ≥18 years who had a CV event and received at least 2 lipid-modifying therapy prescriptions within 180 days beforehand. PRIMARY AND SECONDARY OUTCOME MEASURES: Direct medical costs (2014 £) were estimated in 3 periods: baseline (pre-event), acute (6 months afterwards) and long-term (subsequent 30 months). Primary outcomes included incremental costs, resource usage and total costs per period. RESULTS: There were 24 093 patients in the first event cohort of whom 5274 were included in the second event cohort. The mean incremental acute CV event costs for the first event and second event cohorts were: coronary artery bypass graft/percutaneous transluminal coronary angioplasty (CABG/PTCA) £5635 and £5823, myocardial infarction £4275 and £4301, ischaemic stroke £3512 and £4572, heart failure £2444 and £3461, unstable angina £2179 and £2489 and transient ischaemic attack £1537 and £1814. The mean incremental long-term costs were: heart failure £848 and £2829, myocardial infarction £922 and £1385, ischaemic stroke £973 and £682, transient ischaemic attack £705 and £1692, unstable angina £328 and £677, and CABG/PTCA £−368 and £599. Hospitalisation accounted for 95% of acute and 61% of long-term incremental costs. Higher comorbidity was associated with higher long-term costs. CONCLUSIONS: Revascularisation and myocardial infarction were associated with the highest incremental costs following a CV event. On the basis of real-world data, the economic burden of CV events in the UK is substantial, particularly among those with greater comorbidity burden.
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spelling pubmed-49859702016-08-19 Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK Danese, Mark D Gleeson, Michelle Kutikova, Lucie Griffiths, Robert I Azough, Ali Khunti, Kamlesh Seshasai, Sreenivasa Rao Kondapally Ray, Kausik K BMJ Open Health Services Research OBJECTIVES: To characterise the costs to the UK National Health Service of cardiovascular (CV) events among individuals receiving lipid-modifying therapy. DESIGN: Retrospective cohort study using Clinical Practice Research Datalink records from 2006 to 2012 to identify individuals with their first and second CV-related hospitalisations (first event and second event cohorts). Within-person differences were used to estimate CV-related outcomes. SETTING: Patients in the UK who had their first CV event between January 2006 and March 2012. PARTICIPANTS: Patients ≥18 years who had a CV event and received at least 2 lipid-modifying therapy prescriptions within 180 days beforehand. PRIMARY AND SECONDARY OUTCOME MEASURES: Direct medical costs (2014 £) were estimated in 3 periods: baseline (pre-event), acute (6 months afterwards) and long-term (subsequent 30 months). Primary outcomes included incremental costs, resource usage and total costs per period. RESULTS: There were 24 093 patients in the first event cohort of whom 5274 were included in the second event cohort. The mean incremental acute CV event costs for the first event and second event cohorts were: coronary artery bypass graft/percutaneous transluminal coronary angioplasty (CABG/PTCA) £5635 and £5823, myocardial infarction £4275 and £4301, ischaemic stroke £3512 and £4572, heart failure £2444 and £3461, unstable angina £2179 and £2489 and transient ischaemic attack £1537 and £1814. The mean incremental long-term costs were: heart failure £848 and £2829, myocardial infarction £922 and £1385, ischaemic stroke £973 and £682, transient ischaemic attack £705 and £1692, unstable angina £328 and £677, and CABG/PTCA £−368 and £599. Hospitalisation accounted for 95% of acute and 61% of long-term incremental costs. Higher comorbidity was associated with higher long-term costs. CONCLUSIONS: Revascularisation and myocardial infarction were associated with the highest incremental costs following a CV event. On the basis of real-world data, the economic burden of CV events in the UK is substantial, particularly among those with greater comorbidity burden. BMJ Publishing Group 2016-08-05 /pmc/articles/PMC4985970/ /pubmed/27496237 http://dx.doi.org/10.1136/bmjopen-2016-011805 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Health Services Research
Danese, Mark D
Gleeson, Michelle
Kutikova, Lucie
Griffiths, Robert I
Azough, Ali
Khunti, Kamlesh
Seshasai, Sreenivasa Rao Kondapally
Ray, Kausik K
Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK
title Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK
title_full Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK
title_fullStr Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK
title_full_unstemmed Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK
title_short Estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the UK
title_sort estimating the economic burden of cardiovascular events in patients receiving lipid-modifying therapy in the uk
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4985970/
https://www.ncbi.nlm.nih.gov/pubmed/27496237
http://dx.doi.org/10.1136/bmjopen-2016-011805
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