Cost-effectiveness analysis with defined budget: how to distribute resources for the prevention of cardiovascular disease?

The aim of the study was to undertake cost-effectiveness calculations subje ct to a defined budget. The setting chosen was the prevention of cardiovasc ular disease (CVD) by means of three intervention programmes in a Swedish c ounty council. The population in the county was divided into subgroups acco rding to risk level. For each subgroup the cost per years of life saved was calculated, as well as the annual budget claims. The budget available was defined as present direct cost in the programmes. The calculations resulted in a programming solution showing the optimal distribution of resources be tween the programmes. Also a league table was constructed and the cut-off v alue for 'acceptable' cost-effectiveness was shown. The conclusion that can be drawn is that a combination of internationally published intervention r esults and local data regarding epidemiology and resources improves the acc uracy and usefulness of cost-effectiveness ratios. However, the model prese nted is a first attempt containing only three interventions: the planned ne xt phase is to integrate more interventions in the model. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.