Stephen J.LurieMD, PhD, Senior Editor
To the Editor: In their cost-effectiveness analysis of vitamin supplementation to lower homocysteine levels and prevent coronary heart disease, Dr Tice and colleagues1 did not use data from beyond February 1999. The modeling in Table 1 of their article is actually not needed, since 2 controlled total homocysteine (tHcy)–lowering treatment studies have been conducted in the United States and Canada among patients with coronary artery disease who have been chronically exposed to a background of folic acid–fortified cereal grain flour since 1999.2,3 These studies show that tHcy-lowering effects are only one third to one half of those listed by Tice et al.
Bostom AG. Cost-effectiveness of Homocysteine-Lowering Therapy to Prevent Coronary Heart Disease. JAMA. 2002;287(2):190. doi:10.1001/jama.287.2.190-JLT0109-3-1