Epidemiologic studies have suggested that
vitamin E (
alpha-tocopherol) may play a preventive role in reducing the incidence of
atherosclerosis. The aim of this paper was to conduct a cost-effectiveness analysis of
vitamin E supplementation in patients with
coronary artery disease using data from the Cambridge Heart
Antioxidant Study (CHAOS). The study compared cost-effectiveness in the context of Australian and United States (US) health care utilization. The main clinical outcome used in the economic evaluation was the incidence of acute
myocardial infarction (AMI) which was nonfatal. Utilization of health care resources was estimated by conducting a survey of Australian clinicians and published Australian and US cost data. Cost savings of $127 (A$181) and $578/patient randomized to
vitamin E therapy compared with patients receiving placebo were found for Australian and US settings, respectively. Savings in the
vitamin E group were due primarily to reduction in hospital admissions for AMI. This occurred because the
vitamin E group had a 4.4% lower absolute risk of AMI than did the placebo group. Less than 10% of health care costs in the Australian evaluation was due to
vitamin E ($150 [A$214/patient]). Our economic evaluation indicates that
vitamin E therapy in patients with angiographically proven
atherosclerosis is cost-effective in the Australian and US settings.