2020 Fiscal Year Final Research Report
Cost-effectiveness of low-density lipoprotein cholesterol-lowering therapeutic interventions for the primary prevention of cardiovascular disease based on patient characteristics
| Project/Area Number |
17K08945
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Medical sociology
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| Research Institution | National Cardiovascular Center Research Institute |
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Principal Investigator |
Takegami Misa 国立研究開発法人国立循環器病研究センター, 研究所, 室長 (50456860)
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| Co-Investigator(Kenkyū-buntansha) |
森脇 健介 立命館大学, 総合科学技術研究機構, 准教授 (10514862)
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| Project Period (FY) |
2017-04-01 – 2021-03-31
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| Keywords | 脂質低下療法 / 脂質異常症 / 費用対効果 / 一次予防 |
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| Outline of Final Research Achievements |
The clinical efficacy of lipid-lowering therapy in the treatment of cardiovascular disease is clear. Nonetheless, there is controversy regarding which patients should receive lipid-lowering therapy for primary prevention in Japan, where the incidence of cardiovascular disease is lower than in Europe and the United States. In this study, we examined the effect of lipid-lowering therapy on the primary prevention of cardiovascular disease from a socioeconomic perspective, using evidence from epidemiological studies in Japan. The results of the cost-effectiveness analysis using a Markov model suggested that the cost-effectiveness of lipid-lowering therapy was low in subjects with no cardiovascular disease risk, other than hypercholesterolemia, based on the willingness-to-pay amount in Japan. The cost-effectiveness of lipid-lowering therapy differs substantially according to the level of cardiac risk.
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| Free Research Field |
疫学
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| Academic Significance and Societal Importance of the Research Achievements |
脂質異常症の患者が増えるに従い、脂質低下療法の必要性が高まっている。心血管疾患の一次予防としての脂質低下療法をどのような患者に実施すべきかどうかは、臨床的な観点だけでなく、社会経済的な観点からの評価も必要である。脂質異常症の患者における心血管疾患の発症リスクは同じではなく、心血管疾患のリスク因子の保有により、心血管疾患の発症リスクは異なる。患者の脂質以外の心血管疾患のリスク因子を保有している患者およびリスク因子の保有パターンごとに脂質低下治療薬の費用対効果を検討した結果、治療の費用対効果が高い集団が明らかとなった。本研究の結果は、公衆衛生学的な予防・治療戦略上の意思決定の一助となる。
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