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(Circulation. 2002;106:516.)
© 2002 American Heart Association, Inc.

Clinical Cardiology: New Frontiers

Medical Economics and the Assessment of Value in Cardiovascular Medicine: Part I

Daniel B. Mark, MD, MPH; Mark A. Hlatky, MD

From the Outcomes Research and Assessment Group (D.B.M.), Duke Clinical Research Institute, Durham, NC, and the Department of Health Research and Policy (M.A.H.), Stanford University, Stanford, Calif.

Correspondence to Daniel B. Mark, MD, MPH, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715. E-mail daniel.mark@duke.edu

Key Words: cost-benefit analysis • cardiovascular diseases • financing

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Healthcare costs have been rising in the United States, as they have in the rest of the developed world, for decades. Although many factors contribute to this rise, a major cause is the continued development of new and more expensive medical technologies and treatments. Medical discoveries lead to new diagnostic tests, new pharmaceuticals, new devices, and new surgical procedures. The globalization of medical development through large international mega-trials and the spread of information via the Internet suggest that technological innovation will continue to increase patient expectations and medical costs across the world. The public wants improved medical technology, yet it also wants health care to be affordable and accessible to everyone, regardless of the patient’s ability to pay. How can these conflicting goals be reconciled? The principles of economics can be helpful in assessing when a medical innovation is worth the cost. Our goal in this 2-part series is to present a framework for economic evaluation in cardiovascular medicine (Part I), and to use this framework to evaluate recent work in the areas of coronary revascularization, cholesterol-lowering therapy, and treatment of heart failure (Part II). These topics are not only clinically important, but they also serve to illustrate issues centering around the economic evaluation of expensive one-time treatments, prevention, and ongoing therapy for chronic conditions, respectively. Finally, we will discuss future directions for the emerging field of economic evaluation. At the end of Part I, we have included a glossary of terms commonly used in the literature of medical economics . . . [Full Text of this Article]

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