Coronary Heart Disease
Cost-effectiveness of vitamin E therapy in the treatment of patients
with angiographically proven coronary narrowing (CHAOS trial). Cambridge
Heart Antioxidant Study.
Davey PJ; Schulz M; Gliksman M; Dobson M; Aristides M; Stephens NG
Am J Cardiol 1998 Aug 15;82(4):414-7
Epidemiologic studies have suggested that vitamin E (alpha-tocopherol)
may play a preventive role in reducing the incidence of atherosclerosis.
The aim of this paper was to conduct a cost-effectiveness analysis of
vitamin E supplementation in patients with coronary artery disease using
data from the Cambridge Heart Antioxidant Study (CHAOS). The study compared
cost-effectiveness in the context of Australian and United States (US)
health care utilization. The main clinical outcome used in the economic
evaluation was the incidence of acute myocardial infarction (AMI) which
was nonfatal. Utilization of health care resources was estimated by conducting
a survey of Australian clinicians and published Australian and US cost
data. Cost savings of $127 (A$181) and $578/patient randomized
to vitamin E therapy compared with patients receiving placebo were found
for Australian and US settings, respectively. Savings in the vitamin E
group were due primarily to reduction in hospital admissions for AMI.
This occurred because the vitamin E group had a 4.4% lower absolute risk
of AMI than did the placebo group. Less than 10% of health care
costs in the Australian evaluation was due to vitamin E ($150 [A$214/patient]).
Our economic evaluation indicates that vitamin E therapy in patients
with angiographically proven atherosclerosis is cost-effective in the
Australian and US settings.