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Incorporation of economic evidence in the Dutch guideline ‘cardiovascular risk management’

Authors

  • Siok Swan Tan PhD,

    Corresponding author
    1. Health Economist, Erasmus Universiteit Rotterdam, Institute for Medical Technology Assessment, Rotterdam, the Netherlands
      Ms Siok Swan Tan, Erasmus Universiteit Rotterdam, Institute for Medical Technology Assessment, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands, E-mail: tan@bmg.eur.nl
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  • Frans F. H. Rutten PhD,

    1. Health Economist, Erasmus Universiteit Rotterdam, Institute for Medical Technology Assessment, Rotterdam, the Netherlands
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  • Leona Hakkaart-van Roijen PhD

    1. Health Economist, Erasmus Universiteit Rotterdam, Institute for Medical Technology Assessment, Rotterdam, the Netherlands
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Ms Siok Swan Tan, Erasmus Universiteit Rotterdam, Institute for Medical Technology Assessment, P.O. Box 1738, 3000 DR Rotterdam, the Netherlands, E-mail: tan@bmg.eur.nl

Abstract

Rationale, aims and objectives  The consideration of economic evidence in guideline development may be particularly important in health care management when different (drug) therapies show similar efficacy on clinical endpoints, such as in cardiovascular diseases. This article investigates to what extent the Dutch guideline ‘cardiovascular risk management’ (2006) considers cost-effectiveness and budget impact according to the most recent economic evidence.

Method  We carried out a systematic review of economic evaluations on cholesterol-lowering drugs and antihypertensives followed by an assessment of guideline recommendations.

Results  The guideline does not consider the most recent economic evidence but does consider cost-effectiveness based on economic evaluations performed in conjunction with clinical trials. Their conclusions are largely in agreement with the most recent economic evidence. An innovative aspect in the guideline is the application of a budget impact analysis to take accessibility and affordability constraints into account when considering cost-effectiveness.

Conclusions  Based on the most recent economic evidence, the guideline could be improved by more firmly formulating recommendations in favour of cost-effective drug therapies (simvastatin, pravastatin and low-dose diuretics) to stimulate compliance to the guideline in clinical practice.

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