Treating hyperlipidemia for the primary prevention of coronary disease : Are higher dosages of lovastatin cost-effective ?
To compare the average and marginal lifetime cost-effectiveness of increasing dosages of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, such as lovastatin, for the primary prevention of coronary heart disease (CHD).
We estimated the lifelong costs and benefits of the modification of lipid levels achieved with lovastatin based on published studies and a validated CHD prevention computer model.
Patients were middle-aged men and women without CHD, with mean total serum cholesterol levels of 6.67,7.84, and 9.90 mmol/L (258,303, and 383 mg/dL), and high-density lipoprotein cholesterol levels of 1.19 mmol/L (46 mg/dL), as described in clinical trials.
We estimated the cost per year of life saved for dosages of lovastatin ranging from 20 to 80 mg/d that reduced the total cholesterol level between 17% and 34%, and increased high-density lipoprotein cholesterol level between 4% and 13%. Results : After discounting benefits and costs by 5% annually, the average cost-effectiveness of lovastatin, 20 mg/d, ranged from $11 040 to $52 463 for men and women.
The marginal cost-effectiveness of 40 mg/d vs 20 mg/d remained in this range ($25 711 to $60 778) only for persons with baseline total cholesterol levels of 7.84 mmol/L (303 mg/dL) or higher. (...)
Mots-clés Pascal : Lovastatine, Chimiothérapie, Inhibiteur enzyme, Hydroxymethylglutaryl-CoA reductase, Oxidoreductases, Enzyme, Hypolipémiant, Traitement, Hyperlipémie, Cardiopathie coronaire, Prévention, Analyse coût efficacité, Economie santé, Homme, Lipide, Métabolisme pathologie, Dyslipémie, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Lovastatin, Chemotherapy, Enzyme inhibitor, Hydroxymethylglutaryl-CoA reductase, Oxidoreductases, Enzyme, Antilipemic agent, Treatment, Hyperlipemia, Coronary heart disease, Prevention, Cost efficiency analysis, Health economy, Human, Lipids, Metabolic diseases, Dyslipemia, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0154833
Code Inist : 002B02N. Création : 21/07/1998.