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February 28, 2001

Underuse of β-Blockers Following Myocardial Infarction—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;285(8):1013. doi:10.1001/jama.285.8.1013

In Reply: Although we agree with Drs Budnitz and Neuman that implementation costs are conceptually relevant, including such costs would not have substantially changed our results or conclusions. Certainly there would have to be some intervention costs to increase β-blocker use but, as Budnitz and Neuman note, there are scant data on implementation costs. Furthermore, there are so many types of conceivable interventions—with a wide range of marginal costs and effects, as well as possible collateral benefits—that any such sensitivity analyses would be difficult to interpret.