Kardiologie up2date 2008; 4(3): 201-205
DOI: 10.1055/s-2008-1077590
Hotline – Koronare Herzerkrankung und Atherosklerose

© Georg Thieme Verlag KG Stuttgart · New York

Kann man durch Prävention Geld einsparen?

Helmut  Gohlke
Further Information

Publication History

Publication Date:
29 October 2008 (online)

Abstract

Cost-effectiveness is dependent on the global risk of the patient to be treated, the effectiveness of the treatment modality and the costs of the treatment. These baseline factors modify the number needed to treat (NNT) which should be determined to help in the decision for or against treatment. In all patients above 40 with more than one risk factor a risk stratification with one of the scoring systems should be done to identify persons in whom treatment of risk factors is clinically warranted and cost-effective.

Cost-effectiveness of prevention may be viewed from the perspective of the patient, the insurance company or the retirement fund and may be modified by age and gender. Indirect costs are largely modified by nonmedical factors like employment status, absence from work etc.

In Persons with a global 10 year risk of 20 % or higher and in patients with established atherosclerosis treatment with statins, ASS and intensive efforts for life style changes individually and together are likely to be cost-effective. In women however ASS is less effective in preventing myocardial infarction, therefore alternative ways of prevention should be considered. Also in patients with a prominent single risk factor and a global 10 year risk in the intermediate range (10 – 19 %) the NNT can be below 200 and treatment therefore costeffective. A 10-year global risk of > 20 % and/or a NNT of less than 200 make prevention worthwhile.

Literatur

Professor Dr. med. Helmut Gohlke

Chefarzt Klinische Kardiologie II
Herz-Zentrum Bad Krozingen

Südring 15
79189 Bad Krozingen

Email: [email protected]