Epidemiologic studies have suggested that vitamin E (alpha-tocopherol) may play 
a preventive role in reducing the incidence of atherosclerosis. The aim of this 
paper was to conduct a cost-effectiveness analysis of vitamin E supplementation 
in patients with coronary artery disease using data from the Cambridge Heart 
Antioxidant Study (CHAOS). The study compared cost-effectiveness in the context 
of Australian and United States (US) health care utilization. The main clinical 
outcome used in the economic evaluation was the incidence of acute myocardial 
infarction (AMI) which was nonfatal. Utilization of health care resources was 
estimated by conducting a survey of Australian clinicians and published 
Australian and US cost data. Cost savings of $127 (A$181) and $578/patient 
randomized to vitamin E therapy compared with patients receiving placebo were 
found for Australian and US settings, respectively. Savings in the vitamin E 
group were due primarily to reduction in hospital admissions for AMI. This 
occurred because the vitamin E group had a 4.4% lower absolute risk of AMI than 
did the placebo group. Less than 10% of health care costs in the Australian 
evaluation was due to vitamin E ($150 [A$214/patient]). Our economic evaluation 
indicates that vitamin E therapy in patients with angiographically proven 
atherosclerosis is cost-effective in the Australian and US settings.