Currently, 6 hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) are marketed in the United States (US).
Given the wide variation in the prices and efficacy of statins, formal cost-effectiveness analysis may improve drug selection decisions.
To assess the cost-effectiveness of statin therapy in primary and secondary prevention of coronary heart disease, we developed a model of the costs and consequences of lipid-regulating therapy and estimated the incremental cost-effectiveness o 5 statins (atorvastatin, fluvastatin, lovastatin, pravastatin, simvastatin) at usual starting doses versus no therapy.
Drug effects on serum lipids were assessed using data approved by the US Food and Drug Administration for product labeling.
Annual risks of coronary event occurrence were estimated using Framingham Heart Study coronary risk equations developed for use in this model.
Current estimates of direct medical costs of coronary heart disease were used to assign costs to health states and acute coronary events.
Main outcome measurements were net cost (statin therapy minus savings in coronary heart disease treatment), gain in life expectancy, and cost per life-year saved.
The maximum gain in li expectancy was achieved with atorvastatin, which also had a lower net cost than lavastatin, pravastatin, and simvastatin.
Compared with fluvastatin, atorvastatin's greater effectiveness is attained at a lower cost per life-year saved. (...)
Mots-clés Pascal : Inhibiteur enzyme, Hydroxymethylglutaryl-CoA reductase, Oxidoreductases, Enzyme, Coût, Economie santé, Exploration, Homme, Cardiopathie coronaire, Etude comparative, Prévention, Traitement, Chimiothérapie, Efficacité traitement, Dyslipémie, Facteur risque, Forme pharmaceutique, Lipide, Hypolipémiant, Appareil circulatoire pathologie, Métabolisme pathologie
Mots-clés Pascal anglais : Enzyme inhibitor, Hydroxymethylglutaryl-CoA reductase, Oxidoreductases, Enzyme, Costs, Health economy, Exploration, Human, Coronary heart disease, Comparative study, Prevention, Treatment, Chemotherapy, Treatment efficiency, Dyslipemia, Risk factor, Dosage form, Lipids, Antilipemic agent, Cardiovascular disease, Metabolic diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0039581
Code Inist : 002B02N. Création : 31/05/1999.