Table 3

Health State Utilities and Costs

VariableBase Case EstimateRangeRef. #
Health state utilities
 Patients without CAD0.95Not varied55
 Patients with CAD and no angina0.88Not varied55
 Patients with CAD and angina0.780.8855
 Patients with nonfatal stroke0.77Not varied54
Portion of CAD patients free of angina at 1 yr
 Aggressive medical therapy alone0.58Not varied21,53
 Aggressive medical therapy and PCI0.66Not varied21,53
 Aggressive medical therapy and CABG0.77Not varied21,53
 No antianginal therapy0.13Not varied21
Costs, $
 Medical therapy for risk factor reduction
  Annual cost of aspirin (81 mg daily)*1010–3058
  Annual cost of simvastatin (20 mg daily)*300200–40058
  Cardiac rehabilitation710600–90062
 Medications for angina
  Annual cost of atenolol (50 mg daily)*3530–6058
  Annual cost of isosorbide mononitrate (60 mg daily)*135100–20058
 Noninvasive diagnostic exams
  CCTA with 64-slice CT629300–800Estimated
  Stress ECG110Not varied61
  Stress echocardiography260Not varied61
  Stress SPECT660Not varied61
  Chest CT300Not varied61
  FDG-PET1,850Not varied40
 Procedures and interventions
  Invasive coronary angiography1,750Not varied61
  PCI (drug-eluting stent)12,840Not varied59
  PCI (bare metal stent)9,580Not varied59
  Coronary artery bypass graft surgery25,500Not varied60
  Video-assisted thoracic surgery13,780Not varied32
  Lobectomy17,620Not varied32
 Nonfatal MI
  Acute care5,6404,500–6,80016
  Annual cost of chronic care4,2003,400–5,00016
 Nonfatal stroke§
  Acute care9,0107,200–10,80016
  Annual cost of chronic care4,1103,300–4,90016

CABG = coronary artery bypass graft; other abbreviations as in Tables 1 and 2.

  • * Medication costs based on bulk purchasing prices;

  • probability of using drug-eluting or bare-metal stents in percutaneous coronary intervention (PCI) derived from national statistics;

  • cost of care represents weighted average across patients with complicated and uncomplicated MIs;

  • § cost of care represents weighted average across patients with varying degrees of disability.