TY - JOUR AU - Cutler,David AU - McClellan,Mark AU - Newhouse,Joseph TI - The Costs and Benefits of Intensive Treatment for Cardiovascular Disease JF - National Bureau of Economic Research Working Paper Series VL - No. 6514 PY - 1998 Y2 - April 1998 UR - http://www.nber.org/papers/w6514 L1 - http://www.nber.org/papers/w6514.pdf N1 - Author contact info: David M. Cutler Department of Economics Harvard University 1875 Cambridge Street Cambridge, MA 02138 Tel: 617/496-5216 Fax: 617/496-8951 E-Mail: dcutler@harvard.edu Mark B. McClellan Director, Engelberg Center for Health Care Reform Senior Fellow, Economic Studies Leonard .D. Schaeffer Director's Chair in Health Policy ,The Brookings Institution 1775 Massachusetts avenue, N.W. Washington, DC 20036 Tel: (202) 741-6567 Fax: NA E-Mail: mmcclellan@brookings.edu Joseph P. Newhouse Division of Health Policy Research and Education Harvard University 180 Longwood Avenue Boston, MA 02115-5899 Tel: 617/432-1325 Fax: 617/432-3503 E-Mail: newhouse@hcp.med.harvard.edu M2 - featured in NBER digest on 1998-10-01 AB - 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. ER -