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Does productivity influence priority setting A case study from the field of CVD prevention.doc

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Cost Effectiveness and Resource Allocation BioMedCentral Research Open Access Does productivity influence priority setting? A case study from the field of CVD prevention Lars Lindholm*1, Emil L?froth1,2 and M?ns Rosén3 Address: 1Ume? International School of Public Health and Centre for Populations Studies: Ageing and Living Conditions Programme, Ume? University, Sweden, 2Centre for Epidemiology, National Board of Health and Welfare, Stockholm, Sweden and 3The Swedish Council on Technology Assessment in Health Care, Stockholm, Sweden Email: Lars Lindholm* - lars.lindholm@epiph.umu.se; Emil L?froth - emil.lofroth@socialstyrelsen.se; M?ns Rosén - mans.rosen@sbu.se * Corresponding author Published: 17 March 2008 Received: 30 May 2007 Accepted: 17 March 2008 Cost Effectiveness and Resource Allocation 2008, 6:6 doi:10.1186/1478-7547-6-6 This article is available from: /content/6/1/6 ? 2008 Lindholm et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract In this case study, different measures aimed at preventing cardiovascular diseases (CVD) in different target groups have been ranked based on cost per QALY from a health care sector perspective and from a societal perspective, respectively. The innovation in this study is to introduce a budget constraint and thereby show exactly which groups would be included or excluded in treatment or intervention programs based on the two perspectives. Approximately 90% of the groups are included in both perspectives. Mainly elderly women are excluded when the societal perspective is used and mainly middle-aged men are excluded when the health care sector perspective is used. Elderly women have a higher risk of CVD and generally lower income than middle-aged me