IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0166103.html
   My bibliography  Save this article

The Long-Term Benefits of Increased Aspirin Use by At-Risk Americans Aged 50 and Older

Author

Listed:
  • David B Agus
  • Étienne Gaudette
  • Dana P Goldman
  • Andrew Messali

Abstract

Background: The usefulness of aspirin to defend against cardiovascular disease in both primary and secondary settings is well recognized by the medical profession. Multiple studies also have found that daily aspirin significantly reduces cancer incidence and mortality. Despite these proven health benefits, aspirin use remains low among populations targeted by cardiovascular prevention guidelines. This article seeks to determine the long-term economic and population-health impact of broader use of aspirin by older Americans at higher risk for cardiovascular disease. Methods and Findings: We employ the Future Elderly Model, a dynamic microsimulation that follows Americans aged 50 and older, to project their lifetime health and spending under the status quo and in various scenarios of expanded aspirin use. The model is based primarily on data from the Health and Retirement Study, a large, representative, national survey that has been ongoing for more than two decades. Outcomes are chosen to provide a broad perspective of the individual and societal impacts of the interventions and include: heart disease, stroke, cancer, life expectancy, quality-adjusted life expectancy, disability-free life expectancy, and medical costs. Eligibility for increased aspirin use in simulations is based on the 2011–2012 questionnaire on preventive aspirin use of the National Health and Nutrition Examination Survey. These data reveal a large unmet need for daily aspirin, with over 40% of men and 10% of women aged 50 to 79 presenting high cardiovascular risk but not taking aspirin. We estimate that increased use by high-risk older Americans would improve national life expectancy at age 50 by 0.28 years (95% CI 0.08–0.50) and would add 900,000 people (95% CI 300,000–1,400,000) to the American population by 2036. After valuing the quality-adjusted life-years appropriately, Americans could expect $692 billion (95% CI 345–975) in net health benefits over that period. Conclusions: Expanded use of aspirin by older Americans with elevated risk of cardiovascular disease could generate substantial population health benefits over the next twenty years and do so very cost-effectively.

Suggested Citation

  • David B Agus & Étienne Gaudette & Dana P Goldman & Andrew Messali, 2016. "The Long-Term Benefits of Increased Aspirin Use by At-Risk Americans Aged 50 and Older," PLOS ONE, Public Library of Science, vol. 11(11), pages 1-12, November.
  • Handle: RePEc:plo:pone00:0166103
    DOI: 10.1371/journal.pone.0166103
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0166103
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0166103&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0166103?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Michaud, Pierre-Carl & Goldman, Dana P. & Lakdawalla, Darius N. & Zheng, Yuhui & Gailey, Adam H., 2012. "The value of medical and pharmaceutical interventions for reducing obesity," Journal of Health Economics, Elsevier, vol. 31(4), pages 630-643.
    2. Gaudette Étienne & Tysinger Bryan & Goldman Dana P. & Cassil Alwyn, 2015. "Health and Health Care of Medicare Beneficiaries in 2030," Forum for Health Economics & Policy, De Gruyter, vol. 18(2), pages 75-96, December.
    3. Kaestner, Robert & Darden, Michael & Lakdawalla, Darius, 2014. "Are investments in disease prevention complements? The case of statins and health behaviors," Journal of Health Economics, Elsevier, vol. 36(C), pages 151-163.
    4. Étienne Gaudette & Dana Goldman & Andrew Messali & Neeraj Sood, 2015. "Do Statins Reduce the Health and Health Care Costs of Obesity?," PharmacoEconomics, Springer, vol. 33(7), pages 723-734, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Daniel Bauer & Darius Lakdawalla & Julian Reif, 2018. "Mortality Risk, Insurance, and the Value of Life," NBER Working Papers 25055, National Bureau of Economic Research, Inc.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Duncan Ermini Leaf & Bryan Tysinger & Dana P. Goldman & Darius N. Lakdawalla, 2021. "Predicting quantity and quality of life with the Future Elderly Model," Health Economics, John Wiley & Sons, Ltd., vol. 30(S1), pages 52-79, November.
    2. Wiktor Adamowicz & Mark Dickie & Shelby Gerking & Marcella Veronesi & David Zinner, 2014. "Household Decision Making and Valuation of Environmental Health Risks to Parents and Their Children," Journal of the Association of Environmental and Resource Economists, University of Chicago Press, vol. 1(4), pages 481-519.
    3. Bührer, Christian & Fetzer, Stefan & Hagist, Christian, 2020. "Adverse selection in the German Health Insurance System – the case of civil servants," Health Policy, Elsevier, vol. 124(8), pages 888-894.
    4. Étienne Gaudette & Dana Goldman & Andrew Messali & Neeraj Sood, 2015. "Do Statins Reduce the Health and Health Care Costs of Obesity?," PharmacoEconomics, Springer, vol. 33(7), pages 723-734, July.
    5. Julia Thornton Snider & Jeffrey Sullivan & Emma van Eijndhoven & Michael K Hansen & Nobel Bellosillo & Cheryl Neslusan & Ellen O’Brien & Ralph Riley & Seth Seabury & Bertram L Kasiske, 2019. "Lifetime benefits of early detection and treatment of diabetic kidney disease," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-13, May.
    6. Friedman, Willa Helterline, 2018. "Antiretroviral drug access and behavior change," Journal of Development Economics, Elsevier, vol. 135(C), pages 392-411.
    7. Thomas W. Carton & Michael Darden & John Levendis & Sang H. Lee & Iben Ricket, 2016. "Comprehensive Indoor Smoking Bans and Smoking Prevalence: Evidence from the BRFSS," American Journal of Health Economics, University of Chicago Press, vol. 2(4), pages 535-556, Fall.
    8. Paul Andres Rodriguez-Lesmes, 2017. "Early diagnosis of chronic conditions and lifestyle modification," Documentos de Trabajo 15639, Universidad del Rosario.
    9. Abraham Abebe Asfaw, 2019. "The effect of prescription drug insurance on health behavior: Evidence from Medicare Part D," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 403-418, March.
    10. Daniel Bauer & Darius Lakdawalla & Julian Reif, 2018. "Mortality Risk, Insurance, and the Value of Life," NBER Working Papers 25055, National Bureau of Economic Research, Inc.
    11. Fichera, Eleonora & Gray, Ewan & Sutton, Matt, 2016. "How do individuals’ health behaviours respond to an increase in the supply of health care? Evidence from a natural experiment," Social Science & Medicine, Elsevier, vol. 159(C), pages 170-179.
    12. Jesse Margolis & Jason Hockenberry & Michael Grossman & Shin-Yi Chou, 2014. "Moral Hazard and Less Invasive Medical Treatment for Coronary Artery Disease: The Case of Cigarette Smoking," NBER Working Papers 20373, National Bureau of Economic Research, Inc.
    13. Witvorapong, Nopphol, 2018. "Healthy behaviours and productive activities among Thai older adults: A repeated cross-sectional analysis," Social Science & Medicine, Elsevier, vol. 213(C), pages 12-19.
    14. Christian Bührer & Stefan Fetzer & Christian Hagist, 2018. "Adverse Selection in the German Health Insurance System – The Case of Civil Servants," WHU Working Paper Series - Economics Group 18-06, WHU - Otto Beisheim School of Management.
    15. Fichera, Eleonora & Emsley, Richard & Sutton, Matt, 2016. "Is treatment “intensity” associated with healthier lifestyle choices? An application of the dose response function," Economics & Human Biology, Elsevier, vol. 23(C), pages 149-163.
    16. Étienne Gaudette & Gwyn C. Pauley & Julie Zissimopoulos, 2016. "Long-term Individual and Population Consequences of Early-life Access to Health Insurance," Working Papers wp355, University of Michigan, Michigan Retirement Research Center.
    17. Cawley, John, 2015. "An economy of scales: A selective review of obesity's economic causes, consequences, and solutions," Journal of Health Economics, Elsevier, vol. 43(C), pages 244-268.
    18. Afschin Gandjour, 2016. "Comment on: “The Role of Chronic Disease, Obesity, and Improved Treatment and Detection in Accounting for the Rise in Healthcare Spending Between 1987 and 2011”," Applied Health Economics and Health Policy, Springer, vol. 14(2), pages 241-241, April.
    19. Fichera, Eleonora & Banks, James & Siciliani, Luigi & Sutton, Matt, 2018. "Does patient health behaviour respond to doctor effort?," Journal of Economic Behavior & Organization, Elsevier, vol. 156(C), pages 225-251.
    20. Christian Frois & Pierre-Yves Cremieux, 2015. "For a Step Change to Curb the Obesity Epidemic," PharmacoEconomics, Springer, vol. 33(7), pages 613-617, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0166103. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.