Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
Copyright 2002 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.2002
To the Editor: Dr Tice and colleagues1 reported that homocysteine-lowering therapy may
be cost-effective in preventing coronary heart disease in a variety of populations.
However, we have 2 concerns.
First, is the Coronary Heart Disease Policy Model still valid? While
this model has been extremely useful in modeling outcomes in cardiovascular
disease in the past, the parameters of the model were derived from a variety
of sources that date back to 1990. However, the epidemiology of cardiovascular
risk factors has changed over the past decade. Tice et al do not mention the
parameters having been updated, potentially limiting the validity of the model
for the early 21st century.
Sunder-Plassmann G, Födinger M. Cost-effectiveness of Homocysteine-Lowering Therapy to Prevent Coronary Heart Disease. JAMA. 2002;287(2):190-192. doi:10.1001/jama.287.2.186