| QALY gains | Incremental costs | ||||||
|---|---|---|---|---|---|---|---|
| Patient group, intervention | Total new user, thousands | Unit QALY gained | Total QALYs, thousands | Total monetized, Can$ millions | Per new user, Can$ | Total costs, Can$ millions | Net monetary benefit, Can$ millions |
| AMI | 511.3 | 147.3 | 7 365.9 | 53 677.2 | 3 850.4 | 3 515.5 | |
| Fibrinolysis | 251.44 | 0.275 | 69.15 | 3 457.3 | 11 784.0 | 2 963.0 | 494.3 |
| ASA | 46.47 | 0.213 | 9.90 | 494.9 | 0.0033 | 0.000152 | 494.9 |
| β-blocker | 41.78 | 0.106 | 4.43 | 221.4 | 615.8 | 25.7 | 195.7 |
| ACE inhibitor and ARB | 29.26 | 0.740 | 21.65 | 1 082.7 | 7 704.0 | 225.4 | 857.2 |
| Clopidogrel | 69.00 | 0.077 | 5.33 | 266.7 | 999.3 | 68.9 | 197.7 |
| Primary PCI | 20.15 | 0.418 | 8.43 | 421.4 | 1.8 | 0.037035 | 421.3 |
| Primary CABG | 0.32 | 0.350 | 0.11 | 5.5 | 11 684.5 | 3.7 | 1.8 |
| Statin | 32.06 | 0.350 | 11.22 | 561.0 | 15 991.2 | 512.6 | 48.4 |
| Community CPR | 9.72 | 0.417 | 4.05 | 202.6 | 2 448.3 | 23.8 | 178.8 |
| Hospital CPR | 11.10 | 1.176 | 13.05 | 652.5 | 2 448.3 | 27.2 | 625.3 |
| ACS | 260.9 | 78.9 | 3 946.8 | 62 069.7 | 1 400.4 | 2 546.4 | |
| ASA and heparin | 35.65 | 0.213 | 7.59 | 379.7 | 0.0033 | 0.000117 | 379.7 |
| ASA alone | 4.25 | 0.213 | 0.90 | 45.2 | 0.0033 | 0.000014 | 45.2 |
| Glycoprotein IIb/IIa | 19.34 | 0.099 | 1.91 | 95.7 | 1 235.9 | 23.9 | 71.8 |
| ACE inhibitor and ARB | 21.82 | 0.740 | 16.15 | 807.4 | 7 704.0 | 168.1 | 639.3 |
| β-blocker | 38.63 | 0.106 | 4.09 | 204.7 | 615.8 | 23.8 | 180.9 |
| Clopidogrel | 67.01 | 0.078 | 5.21 | 260.4 | 999.3 | 67.0 | 193.5 |
| CABG surgery | 20.18 | 1.100 | 22.20 | 1 110.0 | 35 521.6 | 716.9 | 393.1 |
| PCI | 28.93 | 0.418 | 12.10 | 605.2 | 1.8 | 0.1 | 605.1 |
| Statin | 25.06 | 0.350 | 8.77 | 438.5 | 15 991.2 | 400.7 | 37.8 |
| Secondary prevention after AMI | 322.9 | 61.2 | 3 062.4 | 10 698.3 | 637.5 | 2 424.9 | |
| ASA | 81.25 | 0.213 | 17.31 | 865.3 | 0.0033 | 0.00027 | 865.3 |
| β-blocker | 85.77 | 0.142 | 12.18 | 609.0 | 842.7 | 72.3 | 536.7 |
| ACE inhibitor | 55.87 | 0.180 | 10.06 | 502.8 | 2 706.8 | 151.2 | 351.6 |
| Statin | 61.33 | 0.350 | 21.47 | 1 073.3 | 6 581.9 | 403.7 | 669.6 |
| Warfarin | 21.95 | 0.004 | 0.09 | 4.4 | 147.3 | 3.2 | 1.2 |
| Rehabilitation | 16.75 | 0.009 | 0.15 | 7.5 | 419.6 | 7.0 | 0.5 |
| Chronic angina and CHD | 1 491.5 | 555.5 | 27 774.6 | 39 020.4 | 9 066.0 | 18 708.5 | |
| ASA in community | 580.33 | 0.213 | 123.61 | 6 180.6 | 0.0033 | 0.001900 | 6 180.6 |
| Statins in community | 483.34 | 0.314 | 151.77 | 7 588.4 | 6 581.9 | 3 181.3 | 4 407.1 |
| ACE inhibitor | 331.51 | 0.770 | 255.26 | 12 763.0 | 15 087.0 | 5 001.4 | 7 761.6 |
| CABG surgery | 56.10 | 0.400 | 22.44 | 1 122.0 | 11 684.5 | 655.5 | 466.5 |
| Angioplasty | 40.20 | 0.060 | 2.41 | 120.6 | 5 667.1 | 227.8 | –107.2 |
| Hospital heart failure | 46.0 | 8.5 | 426.1 | 6 857.9 | 42.3 | 383.9 | |
| ACE inhibitor | 21.29 | 0.210 | 4.47 | 223.6 | 37.7 | 0.8 | 222.8 |
| β-blocker | 8.51 | 0.137 | 1.17 | 58.3 | 1 368.4 | 11.6 | 46.6 |
| Spironolactone | 2.38 | 0.022 | 0.05 | 2.6 | 570.0 | 1.4 | 1.2 |
| ASA | 8.03 | 0.213 | 1.71 | 85.5 | 0.0033 | 0.000026 | 85.5 |
| Statin | 5.83 | 0.193 | 1.12 | 56.2 | 4 881.7 | 28.5 | 27.8 |
| Community heart failure | 410.4 | 77.4 | 3 871.5 | 6 857.9 | 527.4 | 3 344.1 | |
| ACE inhibitor and ARB | 175.08 | 0.210 | 36.77 | 1 838.3 | 37.7 | 6.6 | 1 831.7 |
| β-blocker | 76.30 | 0.137 | 10.45 | 522.6 | 1 368.4 | 104.4 | 418.2 |
| Spironolactone | 10.38 | 0.022 | 0.22 | 11.2 | 570.0 | 5.9 | 5.2 |
| ASA | 64.60 | 0.213 | 13.76 | 687.9 | 0.0033 | 0.000211 | 687.9 |
| Statin | 84.09 | 0.193 | 16.23 | 811.5 | 4 881.7 | 410.5 | 401.0 |
| Hypertension | 568.7 | 398.1 | 19 903.1 | 1 373.6 | 781.1 | 19 122.0 | |
| All hypertension treatment | 568.66 | 0.700 | 398.06 | 19 903.1 | 1 373.6 | 781.1 | 19 122.0 |
| Hyperlipidemia treatment | 872.4 | 116.9 | 5 845.4 | 10 690.6 | 3 109.0 | 2 736.4 | |
| Statins for primary prevention | 761.19 | 0.134 | 102.00 | 5 099.9 | 3 563.5 | 2 712.5 | 2 387.4 |
| Gemfibrozil | 83.45 | 0.134 | 11.18 | 559.1 | 3 563.5 | 297.4 | 261.7 |
| Niacin | 27.82 | 0.134 | 3.73 | 186.4 | 3 563.5 | 99.1 | 87.2 |
| Heart transplant | 2.0 | 2.9 | 145.5 | 68 287.4 | 134.7 | 10.8 | |
| Heart transplant | 1.97 | 1.475 | 2.91 | 145.5 | 68 287.4 | 134.7 | 10.8 |
| Smoking | 467.5 | 767.0 | 38 347.5 | 111.9 | 420.8 | 37 926.7 | |
| Smoking cessation | 220.28 | 0.990 | 218.08 | 10 903.9 | 111.9 | 420.8 | 10 483.1 |
| Smoking nonstarting | 247.24 | 2.220 | 548.87 | 27 443.6 | 0 | 0 | 27 443.6 |
| Total | 4 953.6 | 2 213.8 | 110 688.8 | 19 969.6 | 90 719.2 | ||
Note: ACE = angiotensin-converting enzyme inhibitor, ACS = acute coronary syndrome, AMI = acute myocardial infarction, ARB = angiotensin receptor blocker, ASA = acetylsalicylic acid, CABG = coronary artery bypass grafting, CHD = coronary heart disease, CPR = cardiopulmonary resuscitation, Gp IIB/IIA – glycoprotein IIb/IIIa, PCI = percutaneous coronary intervention, QALY = quality-adjusted life-year. *Studies used to generate QALYs and costs are included in the cited references.