PURPOSE: Oat ß-glucan reduces cholesterol and, thus, reduces the risk for coronary heart disease (CHD). However, its economic impact has not been well studied. We examine the economic impact of daily intake of =3 g oat ß-glucan in primary prevention of CHD in patients receiving statins or no pharmacologic treatment.
METHODS: A decision model was developed to compare costs and outcomes associated with lowering cholesterol with no pharmacologic treatment and normal diet, no pharmacologic treatment plus =3 g oat ß-glucan daily, and statin therapy plus =3 g oat ß-glucan daily. The population was men 45, 55, or 65 years old without history of cardiovascular disease with 10-year risk for CHD of 5%, 7.5%, or 10%. Clinical efficacy was taken from meta-analyses. Safety data, costs, and utilities were taken from published literature. Cost per quality-adjusted life years and number of first events were reported.
FINDINGS: Maintaining =3 g ß-glucan may be cost-effective in men aged 45, 55, and 65 years with 10-year CHD risks of 5.0%, 7.5%, and 10.0% taking no pharmacologic treatment or on statins and may reduce first events of myocardial infarction and CHD death. Results are sensitive to oat ß-glucan cost but insensitive to changes in other parameters. Maintaining =3 g oat ß-glucan daily remains cost-effective within plausible range of values.
IMPLICATIONS: ß-glucan may be cost-effective for preventing CHD events in middle-aged men, without previous history of cardiovascular events, whose 10-year CHD risk is = 5%. Maintaining daily ß-glucan intake may have considerable impact on first events.
