Prevention of diseases with drugs – savings or costs?
AbstractThe paper discusses three approaches to cardiovascular disease prevention from the economic point of view: national programs for risk reduction, antiplatelet therapy and strategies of lipid lowering therapy. The most cost effective approach for cardiovascular risk reduction is a combination of population-wide prevention and the high-risk program with population screening. The high-risk program without populationwide prevention aggravates socio-economic inequalities. Acetylsalicylic acid is the antiplatelet drug of choice for cardiovascular disease prevention. Alternative antiplatelet drugs are cost-effective only for secondary prevention; clopidogrel only in case of contraindications for acetylsalicylic acid and dipyridamole in combination with acetylsalicylic acid only in the first two years after a cerebrovascular event. The “treat-to-target” model of lipid lowering treatment is less cost effective than an alternative approach to treating the whole population at risk with fixed doses of statins.
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