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Nutrition and Disease

A Mediterranean Diet Is Cost-Effective in Patients with Previous Myocardial Infarction^1–3,

Kim Dalziel^*,4, Leonie Segal^* and Michel de Lorgeril

^* Centre for Health Economics, Faculty of Business and Economics, Monash University, Victoria 3800, Australia and Nutrition, Vieillissement et Maladies Cardiovasculaires (NVMCV), UFR de Médecine, Domaine de la Merci 38056 La Tronche, France

⁴ To whom correspondence should be addressed. E-mail: kim.dalziel{at}buseco.monash.edu.au.

This evaluation aimed to assess the economic performance of the Mediterranean diet for patients after a first acute myocardial infarction (AMI). A cost utility analysis using a Markov model was used to compare the Mediterranean diet to a prudent Western diet over a time frame of 10 years. After a systematic review of the literature, program effectiveness was based on the Lyon Diet Heart Study (605 patients, mean age 54 y, randomized to the Mediterranean diet delivered by a dietician and cardiologist, or a prudent Western diet). Costs were estimated in AU$ [and converted to US$ and Euros ()] based on the resource use to which published unit costs were applied. Cost and benefits were discounted at 5% per annum. The main outcome measure was cost per quality-adjusted life year (QALY) gained. Extensive 1-way sensitivity analyses were performed. The Mediterranean diet compared with a prudent Western diet was estimated to cost AU$1013 (US$703, 579) per QALY gained per person. There was a mean gain in life years of 0.31/person and a gain in quality-adjusted life years of 0.40/person. Based on the published results from the Lyon Diet Heart Study and conservative assumptions, the Mediterranean diet is highly cost-effective for persons after a first AMI and represents an exceptional return on investment. Policy makers should strongly consider the generalizability of results to their own setting.

KEY WORDS: • myocardial infarction • nutrition • Mediterranean diet • economic analysis • cost-effectiveness

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