Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
PharmacoEconomics
Erschienen in: PharmacoEconomics 3/2017

01.03.2017 | Systematic Review

The Valuation of Informal Care in Cost-of-Illness Studies: A Systematic Review

verfasst von: Juan Oliva-Moreno, Marta Trapero-Bertran, Luz Maria Peña-Longobardo, Raúl del Pozo-Rubio

Erschienen in: PharmacoEconomics | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Abstract

Background

There is a growing interest in incorporating informal care in cost-of-illness studies as a relevant part of the economic impact of some diseases.

Objective

The aim of this paper was to review the recent literature valuating the costs of informal care in a group of selected diseases from 2005 to 2015.

Methods

We carried out a systematic review on the economic impact of informal care, focusing on six selected diseases: arthritis or osteoarthritis, cancer, dementia, mental diseases, multiple sclerosis and stroke.

Results

We selected 91 cost-of-illness articles. The average weight attributed to the informal care cost over the total cost was highly relevant for dementia, stroke, mental diseases, cancer and multiple sclerosis. The most frequent valuation method applied was the opportunity cost method, followed by the proxy good method. The annual cost of informal care presented a high variability depending on the disease and geographic location. Distinguishing by type of illness, the disease with the highest annual value of informal caregiving was dementia, followed by mental illness and multiple sclerosis. The average hourly unit cost was €11.43 (2015 values), varying noticeably depending on the geographic location.

Conclusion

This paper identifies several aspects that should be enhanced to promote comparability between studies and countries, and it sends key messages for incorporating informal care costs to adequately measure the economic impact of diseases.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
World Health Organization. Health and ageing: a discussion paper. Geneva: World Health Organization, Department of Health Promotion, Non-Communicable Disease Prevention and Surveillance; 2001.
2.
Commission European. Healthy ageing: keystone for a sustainable Europe. Brussels: European Commission; 2007.
3.
Kendig H, Phillipson C. Building age-friendly communities: new approaches to challenging health and social inequalities. “If you could do one thing” Nine local actions to reduce health inequalities. London: The British Academy; 2014. p. 102–11.
4.
Iezzoni LI. Policy concerns raised by the growing U.S. population aging with disability. Disabil Health J. 2014;7(1 Suppl):S64–8.
5.
Midtsundstad T, Bogen H. Active Aging policies between individual needs and collective goods. A study of active aging policies and practices in Norway. Nordic J Work Life Stud. 2014;4(2):139–58.CrossRef
6.
Buffel T, McGarry P, Phillipson C, De Donder L, Dury S, De Witte N, et al. Developing age-friendly cities: case studies from Brussels and Manchester and implications for policy and practice. J Aging Soc Policy. 2014;26(1–2):52–72.CrossRefPubMed
7.
Commission European. The 2015 Ageing Report. Directorate-General for Economic and Financial Affairs: Underlying Assumptions and Projection Methodologies. European Commission; 2014.
8.
Lafortune G, Balestat G. Trends in Severe Disability Among Elderly People: Assessing the Evidence in 12 OECD Countries and the Future Implications. Paris: OECD Publishing; 2007. OECD Health Working Papers, No. 26.
9.
Pickard L, King D. Informal care supply and demand in Europe. In: Geerts. J, Willeme P, Mot E, editors. Long-term care use and supply in Europe: projections for Germany, the Netherlands, Spain and Poland. Brussels: European Network of Economic Policy Research Institutes (ENEPRI) Research Report 116; 2012. p. 114–23.
10.
van den Berg B, Brouwer WB, Koopmanschap MA. Economic valuation of informal care. An overview of methods and applications. Eur J Health Econ. 2004;5(1):36–45.CrossRefPubMed
11.
Courtin E, Jemiai N, Mossialos E. Mapping support policies for informal carers across the European Union. Health Policy. 2014;118(1):84–94.CrossRefPubMed
12.
Triantafillou J, Naiditch M, Repkova K, Stiehr K, Carretero S, Emilsson T, et al. Informal care in the long-term care system. European Overview Paper. Athens: Health systems and long-term care for older people in Europe—INTERLINKS Project; 2010.
13.
van Exel J, Bobinac A, Koopmanschap M, Brouwer W. The invisible hands made visible: recognizing the value of informal care in healthcare decision-making. Expert Rev Pharmacoecon Outcomes Res. 2008;8(6):557–61.CrossRefPubMed
14.
van Exel NJ, Brouwer WB, van den Berg B, Koopmanschap M, van den Bos GA. What really matters: an inquiry into the relative importance of dimensions of informal caregiver burden. Clin Rehabil. 2004;18(6):683–93.CrossRefPubMed
15.
Jimenez-Martin S, Prieto CV. The trade-off between formal and informal care in Spain. Eur J Health Econ. 2012;13(4):461–90.CrossRefPubMed
16.
Bauer JM, Sousa-Poza A. Impacts of Informal Caregiving on Caregiver Employment, Health, and Family. J Popul Ageing. 2015;8(3):113–45.CrossRef
17.
Schulz R, Beach SR. Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. JAMA. 1999;282(23):2215–9.CrossRefPubMed
18.
Cohen CA, Colantonio A, Vernich L. Positive aspects of caregiving: rounding out the caregiver experience. Int J Geriatr Psychiatry. 2002;17:184–8.CrossRefPubMed
19.
Brouwer W, Van Exel J, Van Den Berg B, et al. Process utility from providing informal care: the benefit of caring. Health Policy. 2005;74:85–99.CrossRefPubMed
20.
Beach S, Schulz R, Yee J, Jackson S. Negative and positive health effects of caring for a disabled spouse: longitudinal findings from the caregiver health effects study. Psychol Aging. 2000;15:259–71.CrossRefPubMed
21.
Al-Janabi H, Coast J, Flynn T. What do people value when they provide unpaid care to an older person? A meta-ethnography with interview follow-up. Soc Sci Med. 2008;67:111–21.CrossRefPubMed
22.
Michael F. Drummond, Mark J. Sculpher, Karl Claxton, Greg L. Stoddart, and George W. Torrance. Methods for the economic evaluation of health care programmes. Fourth Edition. Oxford University Press. 2015.
23.
Costa N, Ferlicoq L, Derumeaux-Burel H, Rapp T, Garnault V, Gillette-Guyonnet S, et al. Comparison of informal care time and costs in different age-related dementias: a review. Biomed Res Int. 2013;2013:852368.CrossRefPubMed
24.
25.
Pares-Badell O, Barbaglia G, Jerinic P, Gustavsson A, Salvador-Carulla L, Alonso J. Cost of disorders of the brain in Spain. PLoS One. 2014;9(8):e105471.CrossRefPubMedPubMedCentral
26.
Phillipson L, Magee C, Jones SC. Why carers of people with dementia do not utilise out-of-home respite services. Health Soc Care Community. 2013;21(4):411–22.CrossRefPubMed
27.
Quentin W, Riedel-Heller SG, Luppa M, Rudolph A, Konig HH. Cost-of-illness studies of dementia: a systematic review focusing on stage dependency of costs. Acta Psychiatr Scand. 2010;121(4):243–59.CrossRefPubMed
28.
29.
Schaller S, Mauskopf J, Kriza C, Wahlster P, Kolominsky-Rabas PL. The main cost drivers in dementia: a systematic review. Int J Geriatr Psychiatry. 2015;30(2):111–29.CrossRefPubMed
30.
Wineland AM, Stack BC Jr. Modern methods to predict costs for the treatment and management of head and neck cancer patients: examples of methods used in the current literature. Curr Opin Otolaryngol Head Neck Surg. 2008;16(2):113–6.CrossRefPubMed
31.
Heintz E, Gerber-Grote A, Ghabri S, Hamers FF, Rupel VP, Slabe-Erker R, et al. Is there a European view on health economic evaluations? Results from a synopsis of methodological guidelines used in the EUnetHTA partner countries. Pharmacoeconomics. 2016;34(1):59–76.CrossRefPubMed
32.
Jonsson B. Ten arguments for a societal perspective in the economic evaluation of medical innovations. Eur J Health Econ. 2009;10(4):357–9.CrossRefPubMed
33.
Krol M, Papenburg J, Tan SS, Brouwer W, Hakkaart L. A noticeable difference? Productivity costs related to paid and unpaid work in economic evaluations on expensive drugs. Eur J Health Econ. 2016;17(4):391–402.CrossRefPubMed
34.
Krol M, Papenburg J, van Exel J. Does including informal care in economic evaluations matter? A systematic review of inclusion and impact of informal care in cost-effectiveness studies. Pharmacoeconomics. 2015;33(2):123–35.CrossRefPubMed
35.
Goodrich K, Kaambwa B, Al-Janabi H. The inclusion of informal care in applied economic evaluation: a review. Value Health. 2012;15(6):975–81.
36.
Koopmanschap MA, van Ineveld BM. Towards a new approach for estimating indirect costs of disease. Soc Sci Med. 1992;34(9):1005–10.CrossRefPubMed
37.
Liljas B. How to calculate indirect costs in economic evaluations. Pharmacoeconomics. 1998;13(1 Pt 1):1–7.CrossRefPubMed
38.
Krol M, Brouwer W, Rutten F. Productivity costs in economic evaluations: past, present, future. Pharmacoeconomics. 2013;31(7):537–49.CrossRefPubMed
39.
Lensberg BR, Drummond MF, Danchenko N, Despiegel N, Francois C. Challenges in measuring and valuing productivity costs, and their relevance in mood disorders. Clinicoecon Outcomes Res. 2013;5:565–73.CrossRefPubMedPubMedCentral
40.
Oliva J, Lobo F, Lopez-Bastida J, Zozaya N, Romay R. Indirect costs of cervical and breast cancers in Spain. Eur J Health Econ. 2005;6(4):309–13.CrossRefPubMed
41.
Lofland JH, Locklear JC, Frick KD. Different approaches to valuing the lost productivity of patients with migraine. Pharmacoeconomics. 2001;19(9):917–25.CrossRefPubMed
42.
Nicholson S, Pauly MV, Polsky D, Sharda C, Szrek H, Berger ML. Measuring the effects of work loss on productivity with team production. Health Econ. 2006;15(2):111–23.CrossRefPubMed
43.
Tilling C, Krol M, Tsuchiya A, Brazier J, Brouwer W. In or out? Income losses in health state valuations: a review. Value Health. 2010;13(2):298–305.CrossRefPubMed
44.
Nyman JA. Productivity costs revisited: toward a new US policy. Health Econ. 2012;21(12):1387–401.CrossRef
45.
Hoefman RJ, van Exel J, Brouwer W. How to include informal care in economic evaluations. Pharmacoeconomics. 2013;31(12):1105–19.CrossRefPubMed
46.
Koopmanschap MA, van Exel JN, van den Berg B, Brouwer WB. An overview of methods and applications to value informal care in economic evaluations of healthcare. Pharmacoeconomics. 2008;26(4):269–80.CrossRefPubMed
47.
van den Berg B, Spauwen P. Measurement of informal care: an empirical study into the valid measurement of time spent on informal caregiving. Health Econ. 2006;15(5):447–60.CrossRefPubMed
48.
van den Berg B, Brouwer W, van Exel J, Koopmanschap M. Economic valuation of informal care: the contingent valuation method applied to informal caregiving. Health Econ. 2005;14(2):169–83.CrossRefPubMed
49.
van den Berg B, Brouwer W, van Exel J, Koopmanschap M, van den Bos GA, Rutten F. Economic valuation of informal care: lessons from the application of the opportunity costs and proxy good methods. Soc Sci Med. 2006;62(4):835–45.CrossRefPubMed
50.
van den Berg B, Bleichrodt H, Eeckhoudt L. The economic value of informal care: a study of informal caregivers’ and patients’ willingness to pay and willingness to accept for informal care. Health Econ. 2005;14(4):363–76.CrossRefPubMed
51.
van den Berg B, Ferrer ICA. Monetary valuation of informal care: the well-being valuation method. Health Econ. 2007;16(11):1227–44.CrossRefPubMed
52.
de Meijer C, Brouwer W, Koopmanschap M, van den Berg B, van Exel J. The value of informal care–a further investigation of the feasibility of contingent valuation in informal caregivers. Health Econ. 2010;19(7):755–71.CrossRefPubMed
53.
van den Berg B, Al M, Brouwer W, van Exel J, Koopmanschap M. Economic valuation of informal care: the conjoint measurement method applied to informal caregiving. Soc Sci Med. 2005;61(6):1342–55.CrossRefPubMed
54.
van den Berg B, Al M, van Exel J, Koopmanschap M, Brouwer W. Economic valuation of informal care: conjoint analysis applied in a heterogeneous population of informal caregivers. Value Health. 2008;11(7):1041–50.CrossRefPubMed
55.
Mentzakis E, Ryan M, McNamee P. Using discrete choice experiments to value informal care tasks: exploring preference heterogeneity. Health Econ. 2011;20(8):930–44.CrossRefPubMed
56.
Garrido-Garcia S, Sanchez-Martinez FI, Abellan-Perpinan JM, van Exel J. Monetary valuation of informal care based on carers’ and noncarers’ preferences. Value Health. 2015;18(6):832–40.CrossRefPubMed
57.
Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA Group. preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.CrossRefPubMedPubMedCentral
58.
59.
60.
Chari AV, Engberg J, Ray KN, Mehrotra A. The opportunity costs of informal elder-care in the United States: new estimates from the american time use survey. Health Serv Res. 2015;50(3):871–82.CrossRefPubMed
61.
Paraponaris A, Davin B, Verger P. Formal and informal care for disabled elderly living in the community: an appraisal of French care composition and costs. Eur J Health Econ. 2012;13(3):327–36.CrossRefPubMed
62.
Hollander MJ, Liu G, Chappell NL. Who cares and how much? The imputed economic contribution to the Canadian healthcare system of middle-aged and older unpaid caregivers providing care to the elderly. Healthc Q. 2009;12(2):42–9.CrossRefPubMed
63.
Oliva-Moreno J, Peña-Longobardo LM, Vilaplana-Prieto C. An estimation of the value of informal care provided to dependent people in Spain. Appl Health Econ Health Policy. 2015;13(2):223–31.CrossRefPubMed
64.
Carrera F, Pavolini E, Ranci C, Sabbatini A. Long-term care systems in comparative perspective: Care needs, informal and formal coverage, and social impacts in European countries. In: Pavolini E, Ranci C, editors. Reforms in long-term care policies in Europe: Investigating Institutional Change and Social Impacts. New York: Springer-Verlag New York; 2013. p. 23–52.
65.
Costa-Font J, Zigante V. Long Term Care Coverage in Europe: A Case for ‘Implicit Insurance Partnerships’. London: The London School of Economics and Political Science; 2014. LSE Health Working Paper, No. 37.
66.
Neubauer S, Holle R, Menn P, Grossfeld-Schmitz M, Graesel E. Measurement of informal care time in a study of patients with dementia. Int Psychogeriatr. 2008;20(6):1160–76.CrossRefPubMed
67.
Trepel D. Informal cost of dementia care- a proxy-good valuation in Ireland. Econ Soc Rev (Irel). 2011;42(4):479–503.
68.
Peña-Longobardo LM, Oliva-Moreno J. Economic valuation and determinants of informal care to people with Alzheimer’s disease. Eur J Health Econ. 2015;16(5):507–15.CrossRefPubMed
69.
Yabroff KR, Kim Y. Time costs associated with informal caregiving for cancer survivors. Cancer. 2009;115(18 Suppl):4362–73.CrossRefPubMed
70.
Albrecht D, Wollensak T, Ernst C, Becker C, Hautzinger M, Pfeiffer K. Costs of informal care in a sample of German geriatric stroke survivors. Eur J Ageing. 2016;13(1):49–61.CrossRef
71.
Hanly P, Ceilleachair AO, Skally M, O’Leary E, Staines A, Kapur K, et al. Time costs associated with informal care for colorectal cancer: an investigation of the impact of alternative valuation methods. Appl Health Econ Health Policy. 2013;11(3):193–203.CrossRefPubMed
72.
73.
Gerves C, Chauvin P, Bellanger MM. Evaluation of full costs of care for patients with Alzheimer’s disease in France: the predominant role of informal care. Health Policy. 2014;116(1):114–22.CrossRefPubMed
74.
Wimo A, Reed CC, Dodel R, Belger M, Jones RW, Happich M, et al. The GERAS Study: a prospective observational study of costs and resource use in community dwellers with Alzheimer’s disease in three European countries–study design and baseline findings. J Alzheimers Dis. 2013;36(2):385–99.PubMed
75.
Wolff N, Perlick DA, Kaczynski R, Calabrese J, Nierenberg A, Miklowitz DJ. Modeling costs and burden of informal caregiving for persons with bipolar disorder. J Ment Health Policy Econ. 2006;9(2):99–110.PubMed
76.
Wubker A, Zwakhalen SM, Challis D, Suhonen R, Karlsson S, Zabalegui A, et al. Costs of care for people with dementia just before and after nursing home placement: primary data from eight European countries. Eur J Health Econ. 2015;16(7):689–707.CrossRefPubMed
77.
Bolin K, Lindgren B, Lundborg P. Informal and formal care among single-living elderly in Europe. Health Econ. 2008;17(3):393–409.CrossRefPubMed
78.
Chappell N, Blandford A. Informal and formal care: exploring the complementarity. Ageing Soc. 1991;11(03):299–317.CrossRef
79.
Denton M. The linkages between informal and formal care of the elderly. Can J Aging. 1997;16(01):30–50.CrossRef
80.
Greene VL. Substitution between formally and informally provided care for the impaired elderly in the community. Med Care. 1983:609–19.
81.
Kehusmaa S, Autti-Ramo I, Helenius H, Rissanen P. Does informal care reduce public care expenditure on elderly care? Estimates based on Finland’s Age Study. BMC Health Serv Res. 2013;13:317.CrossRefPubMedPubMedCentral
82.
Lee MJ, Kim YS. Zero-inflated endogenous count in censored model: effects of informal family care on formal health care. Health Econ. 2012;21(9):1119–33.CrossRefPubMed
83.
Litwak E. Helping the elderly: the complementary roles of informal networks & formal systems. New York: The Guilford Press; 1985.
84.
Mentzakis E, McNamee P, Ryan M. Who cares and how much: exploring the determinants of co-residential informal care. Rev Econ Househ. 2009;7(3):283–303.CrossRef
85.
Moscovice I, Davidson G, McCaffrey D. Substitution of formal and informal care for the community-based elderly. Med Care. 1988;26(10):971–81.CrossRefPubMed
86.
Muramatsu N, Campbell RT. State expenditures on home and community based services and use of formal and informal personal assistance: a multilevel analysis. J Health Soc Behav. 2002;43(1):107–24.CrossRefPubMed
87.
Van Houtven CH, Norton EC. Informal care and health care use of older adults. J Health Econ. 2004;23(6):1159–80.CrossRefPubMed
88.
Arno PS, Levine C, Memmott MM. The economic value of informal caregiving. Health Aff (Millwood). 1999;18(2):182–8.CrossRefPubMed
89.
Saltman RB, Dubois HF, Chawla M. The impact of aging on long-term care in Europe and some potential policy responses. Int J Health Serv. 2006;36(4):719–46.CrossRefPubMed
90.
Fujisawa R, Colombo F. The Long-Term Care Workforce: overview and strategies to adapt supply to a growing demand. Paris: OECD Publishing; 2009. OECD Health Working Papers, No. 44.
91.
Fernandez JL, Forder J, Trukeschitz B, Rokasova M, McDaid D. How can European states design efficient, equitable and sustainable funding systems for long-term care for older people? Copenhagen: WHO Regional Office for Europe; 2009. European Observatory on Health Systems and Policies. Policy Brief, No. 11.
92.
Nolte H, Pitchforth E. What is the evidence on the economic impacts of integrated care? Copenhagen: WHO Regional Office for Europe; 2014. European Observatory on Health Systems and Policies. Policy Summary, No. 11.
93.
Viitanen TK. Informal and Formal Care in Europe. Bonn: IZA, Institute for the Study of Labor; 2007. Discussion Paper Series, No. 2648.
94.
Glanville J, Paisley S. Searching for evidence on resource use, costs, effects and cost-effectiveness. In: Shemilt I et al (editors) Evidence based economics. Oxford: Wiley-Blackwell;2010.
95.
McKinlay RJ, Wilczynski NL, Haynes RB, the Hedges Team. Optimal search strategies for detecting cost and economic studies in EMBASE. BMC Health Serv Res 2006;6:67.
96.
Coyle KB, Trochlil K, Iversen P. MEDLINE and EMBASE for health economic literature reviews [abstract]. Value Health. 2012;15(4):A162.CrossRef
97.
Sassi F, Archard L. McDaid d. Searching literature databases for health care economic evaluations: how systematic can we afford to be? Med Care. 2002;40(5):387–94.CrossRefPubMed
98.
Shemilt I, Mugford M, Vale L, Craig D. Searching NHS EED and HEED to inform development of economic commentary for Cochrane intervention reviews. Oxford: Cochrane Collaboration; 2011.
99.
Hanly P, Ceilleachair AO, Skally M, O’Leary E, Kapur K, Fitzpatrick P, et al. How much does it cost to care for survivors of colorectal cancer? Caregiver’s time, travel and out-of-pocket costs. Support Care Cancer. 2013;21(9):2583–92.CrossRefPubMed
100.
Boyd KJ, Murray SA, Kendall M, Worth A, Frederick Benton T, Clausen H. Living with advanced heart failure: a prospective, community based study of patients and their carers. Eur J Heart Fail. 2004;6(5):585–91.CrossRefPubMed
101.
Hamalainen H, Smith R, Puukka P, Lind J, Kallio V, Kuttila K, et al. Social support and physical and psychological recovery one year after myocardial infarction or coronary artery bypass surgery. Scand J Public Health. 2000;28(1):62–70.PubMed
102.
Haley WE, Allen JY, Grant JS, Clay OJ, Perkins M, Roth DL. Problems and benefits reported by stroke family caregivers: results from a prospective epidemiological study. Stroke. 2009;40(6):2129–33.CrossRefPubMedPubMedCentral
Metadaten
Titel
The Valuation of Informal Care in Cost-of-Illness Studies: A Systematic Review
verfasst von
Juan Oliva-Moreno
Marta Trapero-Bertran
Luz Maria Peña-Longobardo
Raúl del Pozo-Rubio
Publikationsdatum
01.03.2017
Verlag
Springer International Publishing
Erschienen in
PharmacoEconomics / Ausgabe 3/2017
Print ISSN: 1170-7690
Elektronische ISSN: 1179-2027
DOI
https://doi.org/10.1007/s40273-016-0468-y

Weitere Artikel der Ausgabe 3/2017

PharmacoEconomics 3/2017 Zur Ausgabe

Practical Application

Weighing Clinical Evidence Using Patient Preferences: An Application of Probabilistic Multi-Criteria Decision Analysis

Systematic Review

Valuing Meta-Health Effects for Use in Economic Evaluations to Inform Reimbursement Decisions: A Review of the Evidence

Review Article

Azacitidine for Treating Acute Myeloid Leukaemia with More Than 30 % Bone Marrow Blasts: An Evidence Review Group Perspective of a National Institute for Health and Care Excellence Single Technology Appraisal

Systematic Review

A Systematic Review and Critical Appraisal of Economic Evaluations of Pharmacological Interventions for People with Bipolar Disorder

Original Research Article

Validation of the Economic and Health Outcomes Model of Type 2 Diabetes Mellitus (ECHO-T2DM)

Systematic Review

A Systematic Review of Cardiovascular Outcomes-Based Cost-Effectiveness Analyses of Lipid-Lowering Therapies