The Costs and Benefits of Intensive Treatment for Cardiovascular Disease

51 Pages Posted: 27 Jun 2000 Last revised: 26 Oct 2022

See all articles by David M. Cutler

David M. Cutler

Harvard University - Department of Economics; National Bureau of Economic Research (NBER); Harvard University - Harvard Kennedy School (HKS)

Mark B. McClellan

Brookings Institution; Council of Economic Advisors; National Bureau of Economic Research (NBER)

Joseph P. Newhouse

Harvard Medical School; Harvard Kennedy School (HKS); National Bureau of Economic Research (NBER); Harvard University - Harvard Kennedy School (HKS)

Date Written: April 1998

Abstract

This paper examines the causes and consequences of reductions in cardiovascular disease mortality, and in particular heart attack mortality, over the past several decades. Analysis of data from Medicare and review of the clinical literature indicate that a large share of the recent decline in heart attack mortality is a result of new medical interventions and increased use of existing interventions. Much of the mortality improvement appears to be the result of changes in the use of pharmaceuticals such as aspirin and clot-busting (thrombolytic) drugs. Greater use of these and other intensive medical procedures have increased the cost of treating heart attacks but have also lead to health improvements. We estimate that the value of improved health is greater than the increased cost of heart attack care, so that the cost of living for people with a heart attack is falling. We present preliminary evidence that patients in managed care receive nearly similar treatment for heart attacks compared to patients with traditional indemnity insurance, but that managed care insurers pay less for the same treatments than do traditional insurers.

Suggested Citation

Cutler, David M. and McClellan, Mark B. and Newhouse, Joseph P., The Costs and Benefits of Intensive Treatment for Cardiovascular Disease (April 1998). NBER Working Paper No. w6514, Available at SSRN: https://ssrn.com/abstract=226255

David M. Cutler (Contact Author)

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Mark B. McClellan

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Joseph P. Newhouse

Harvard Medical School; Harvard Kennedy School (HKS) ( email )

Department of Health Care Policy
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National Bureau of Economic Research (NBER)

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Harvard University - Harvard Kennedy School (HKS) ( email )

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