Objectives-To estimate the cost effectiveness of statins in lowering serum cholesterol concentration in people at varying risk of fatal cardiovascular disease and to explore the implications of changing the criteria for intervention on cost and cost effectiveness for a purchasing authority.
Design-A life table method was used to model the effect of treatment with a statin on survival over 10 years in men and women aged 45-64.
The costs of intervention were estimated from the direct costs of treatment, offset by savings associated with a reduction in coronary angiographies, non-fatal myocardial infarctions, and revascularisation procedures.
The robustness of the model to various assumptions was tested in a sensitivity analysis.
Setting-Population of a typical district health authority.
Main outcome measure-Cost per life year saved.
The average cost effectiveness of treating men aged 45-64 with no history of coronary heart disease and a cholesterol concentration>6.5 mmolll for 10 years with a statin was £136 000 per life year saved.
The average cost effectiveness for patients with pre-existing coronary heart disease and a cholesterol concentration>5.4 mmol/l was £32 000.
These averages hide enormous differences in cost effectiveness between groups at different risk, ranging from £6000 per life year in men aged 55-64 who have had a myocardial infarction and whose cholesterol concentration is above 7. (...)
Mots-clés Pascal : Hypercholestérolémie, Cardiopathie coronaire, Hypolipémiant, Facteur risque, Chimiothérapie, Traitement, Association, Homme, Economie santé, Lipide, Coût, Métabolisme pathologie, Hyperlipoprotéinémie, Appareil circulatoire pathologie, Statines
Mots-clés Pascal anglais : Hypercholesterolemia, Coronary heart disease, Antilipemic agent, Risk factor, Chemotherapy, Treatment, Association, Human, Health economy, Lipids, Costs, Metabolic diseases, Hyperlipoproteinemia, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0316333
Code Inist : 002B02N. Création : 10/04/1997.