The cost-effectiveness of secondary prevention of atherothrombotic disease in Western Australia

Emily Atkins

Research output: ThesisDoctoral Thesis

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Abstract

[Truncated] Introduction: Cardiovascular disease requires more of the Australian government health budget than any other disease. Expenditure is estimated to be $14 billion dollars annually (2014 AUD) with half attributed to hospital admissions. Atherothrombotic disease (ATD) is the largest contributor to major cardiovascular events; namely myocardial infarction (MI), ischaemic stroke, lower-limb amputation, and cardiovascular death. Those who have experienced an ATD event and survived remain at high absolute risk of a recurrent or new episode in the same or another vascular territory. Antiplatelet, lipid-lowering, and renin-angiotensin-aldosterone-system agents are recommended to reduce the crossvascular event risk, and therefore prevent further ATD events. Evidence shows that secondary prevention pharmacotherapy is underutilised in Australia and elsewhere. Increasing the level of pharmacotherapy coverage to an optimal level will mean greater expenditure on medicines from the health system perspective although optimal coverage has the potential to reduce disease recurrence, which will mean less expenditure on hospital admissions for these events. This study compares current drug coverage to a hypothetical optimal coverage to evaluate the cost-effectiveness of improved secondary preventive pharmacotherapy for ATD in Western Australia (WA).

Aims

• Estimate the cost-effectiveness of improved secondary preventive pharmacotherapy compared to current treatment for ATD in WA

• Characterise admissions for ATD to tertiary, non-tertiary metropolitan and rural hospitals in WA during 2007

• Determine the health outcomes and estimate hospital costs for ATD in the two years after admission to a tertiary hospital in an Australian setting

• Estimate how many recurrent cardiovascular events could be prevented if optimal cardioprotective pharmacotherapy is practiced

Original languageEnglish
QualificationDoctor of Philosophy
Publication statusUnpublished - 2015

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