Saving lives, money and resources: drug and CABG/PCI use after myocardial infarction in a Swedish record-linkage study
Artikel i vetenskaplig tidskrift, 2010

Drug costs are increasing despite the introduction of cheaper generic drugs. The aim of the present study was to analyse the entire costs of hospital care, out-patient care, and the cost of drugs for 16 months following a myocardial infarction (MI) to see to what extent drug costs contribute to the overall costs of care. Diagnoses and costs for care as well as mortality data obtained from the Vastra Gotaland Region, Sweden, and drug costs from the Swedish Board of Health and Welfare, were merged in a computer file. Patients registered from 1 July 2005 to 30 June 2006 were followed from 28 days after an MI, with follow-up until 31 October 2006. Of 4,725 patients, 711 died before the start of the study and 721 during follow-up. Higher age [hazard ratio (HR, 95%CI) = 1.06 (1.05-1.07)], previous MI [HR = 1.31 (1.13-1.53)] and diabetes mellitus [HR = 1.34 (1.13-1.58)] were associated with increased mortality, which decreased with coronary interventions: CABG/PCI [HR = 0.19 (0.14-0.27)]. In a multivariable analysis, mortality was lower for patients taking simvastatin [HR = 0.62 (0.50-0.76)] and clopidogrel [HR = 0.58 (0.46-0.74)]. Costs for out-patient care accounted for 25% and drugs for 5% of total costs. If patients not treated with simvastatin or clopidogrel had received these drugs, an additional 154-306 lives might have been saved. Drug costs would be higher, but total costs lower. Thus, even expensive drugs may reduce overall costs.

Record linkage

Drug costs

Out-patient costs

Myocardial infarction

Hospital costs

Författare

Lars Wilhelmsen

Göteborgs universitet

L. Welin

Lidköping Hospital

Anders Odén

Göteborgs universitet

Chalmers, Matematiska vetenskaper, matematisk statistik

A. Bjornberg

Pollex Retro Research

European Journal of Health Economics

1618-7598 (ISSN) 1439-6637 (eISSN)

Vol. 11 177-184

Ämneskategorier

Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi

DOI

10.1007/s10198-009-0161-6