Targeted versus universal prevention. a resource allocation model to prioritize cardiovascular prevention

Table 1 Short term costs and effects of interventions (price level 2007)

Intervention	Effectiveness*	Annual costs per participant ^†
General population
Minimal cessation counseling by GP	28	€30
Intensive smoking cessation counseling plus pharmacotherapy	68	€420
Minimal lifestyle intervention, community intervention (Hartslag Limburg^‡)	Activity: 0-1 Overweight: 5-8	€6
Intensive lifestyle intervention for persons with extreme overweight (SLIM^§)	Activity: 1-6 Overweight: 18.	€700
Medication to reduce blood pressure for persons with SBP > 140	390	€1200-€280**
Statins for persons with total cholesterol > 6.5	470	€1500-€3700**
Diabetes patients
Minimal cessation counseling by GP	28	€30
Intensive smoking cessation counseling plus pharmacotherapy	68	€420
Minimal lifestyle intervention (X-PERT^††)	Activity: 50-90 Overweight: 35	€120
Intensive lifestyle intervention (LookAHEAD^‡‡)	Overweight: 140	€500
Medication to reduce blood pressure for persons with SBP > 140^§§	390	€1000-€3300**
Statins for al diabetes patients***	470	€1100-€3800 **

* Short term effects expressed as the number of additional persons per 1000 participants that quit smoking, loose weight, increase activity, or continue lifelong medication. Only continuous drug use was assumed to lead to effects on disease risks, the latter were different for the general population and diabetes patients and for age and baseline risk [30, 32]. Long term effects were age dependent and computed using the RIVM-Chronic Disease Model.
^† Intervention costs only. Effects on costs of care were age dependent and computed in the RIVM-Chronic Disease Model. Earlier publications provide more details on the intervention cost estimates [27–32]. All estimates were adjusted to price level 2007 using consumer price indices.
^‡ Ronkers et al. [34]
^§ Mensink et al. [35]
** Costs of lifetime medication use and consults were age dependent.
^†† Deakin et al. [36]
^‡‡ Pi-Sunyer et al. [37]
^§§ Effects given are the number of persons that continue lifetime medication. Effects of medication on disease risks were based on a meta-analysis [38]. For full details see the RIVM report by Jacobs-van der Bruggen et al. 2007 (available at http://www.rivm.nl/bibliotheek/rapporten/260801004.pdf).
*** Effects given are the number of persons that continue lifetime medication. Effects of medication on disease risks were based on a meta-analysis [6]. For full details see Jacobs-van der Bruggen et al. 2008 [30] and the RIVM report mentioned above.

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