Costs and effectiveness of routine therapy with long-term beta-adrenergic antagonists after acute myocardial infarction

L. Goldman, S. T B Sia, E. F. Cook, J. D. Rutherford, M. C. Weinstein

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Abstract

We analyzed the costs and effectiveness of routine therapy with beta-adrenergic antagonists in patients who survived an acute myocardial infarction. On the basis of data pooled from the literature, this form of therapy resulted in a 25 percent relative reduction annually in the mortality rate for years 1 to 3 and a 7 percent relative reduction for years 4 to 6 after a myocardial infarction. The estimated cost of six years of routine beta-adrenergic-antagonist therapy to save an additional year of life was $23,400 in low-risk patients, $5,900 in medium-risk patients, and $3,600 in high-risk patients, assuming that the entire benefit of earlier treatment is lost immediately after six years. Under a more likely assumption - that the benefit of six years of treatment wears off gradually over the subsequent nine years - the estimated cost of therapy per year of life saved would be $13,000 in low-risk patients, $3,600 in medium-risk patients, and $2,400 in high-risk patients. As compared with coronary-artery bypass grafting and the medical treatment of hypertension, routine beta-adrenergic-antagonist therapy has a relatively favorable cost-effectiveness ratio.

Original languageEnglish (US)
Pages (from-to)152-157
Number of pages6
JournalNew England Journal of Medicine
Volume319
Issue number3
StatePublished - 1988

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Adrenergic beta-Antagonists
Cost-Benefit Analysis
Myocardial Infarction
Therapeutics
Costs and Cost Analysis
Coronary Artery Bypass
Hypertension
Mortality

ASJC Scopus subject areas

  • Medicine(all)

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Costs and effectiveness of routine therapy with long-term beta-adrenergic antagonists after acute myocardial infarction. / Goldman, L.; Sia, S. T B; Cook, E. F.; Rutherford, J. D.; Weinstein, M. C.

In: New England Journal of Medicine, Vol. 319, No. 3, 1988, p. 152-157.

Research output: Contribution to journalArticle

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