COST-EFFECTIVENESS ANALYSIS OF THE PROPHY LAXIS OF MYOCARDIAL REINFARCTION WITH LOW-DOSE ACETYLSALICYLIC-ACID - MODEL CALCULATION

The purpose of this study is to estimate tile potential of savings whi ch can be achieved by prophylaxis of myocardial reinfarction with low- dose acetylsalicylic acid (ASA) at 75 mg per day over a treatment peri od of two years. After secundary analysis of published data, the effec tiveness of low-dose ASA is compared to placebo by a model calculation . The difference in the effectiveness between the prophylaxis with ASA and placebo is taken from an international meta-analysis. The economi c valuation of this difference is carried out by a cost-effectiveness analysis applying disease costs per case. According to the model calcu lation, 5535 DM can be saved per patient with a history of myocardial infarction with 75 mg ASA a day over a treatment period of two years. In 1991 there were around 740000 patients with a history of myocardial infarction in the age group of 25-64 in the Old Bundeslander of the F ederal Republic of Germany. The application of the results of the mode l calculation would lead to considerable savings. Even in the sensitiv ity analysis with a different assumptions regarding costs incurred by hospital treatment and costs incurred by premature retirement, the cos t advantage of the ASA-prophylaxis remains. Due to the cautious and co nservative assumptions in the model calculation the potential of savin gs is likely underestimated Nevertheless, there is a distinct advantag e for the prophylaxis with low-dose ASA which already occurs in direct costs thus leading to advantages also for cost carriers.