Cost-effectiveness of 3-Hydroxy-3-Methylglutaryl–Coenzyme A Reductase Inhibitors in the Secondary Prevention of Cardiovascular Disease

Grover, Steven A.; Coupal, Louis; Paquet, Steeve; Zowall, Hanna

doi:10.1001/archinte.159.6.593

Cited by 61 publications

(47 citation statements)

References 30 publications

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“…[188][189][190][191][192][193] The primary prevention models were all based on the WOSCOPS trial and the secondary prevention models were based on the LIPID (two), 4S (three) and CARE (one) trials. The studies were based on costs in Australia (two studies), Canada, Sweden, The Netherlands and the USA (one each).…”

Section: Results: Non-uk Cost-effectiveness Studiesmentioning

confidence: 99%

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A systematic review and economic evaluation of statins for the prevention of coronary events

Ward

Jones²,

Pandor³

et al. 2007

Health Technol Assess

346

312

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) Programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, the public and consumer groups and professional bodies such as r...

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Section: Results: Non-uk Cost-effectiveness Studiesmentioning

confidence: 99%

“…Model design was described as Markov in two studies, 190,194 survival curve in one study, 192 life table in one study 193 and spreadsheet analysis in one study. 188 One study was an economic evaluation alongside a clinical trial.…”

Section: Model Designmentioning

confidence: 99%

A systematic review and economic evaluation of statins for the prevention of coronary events

Ward

Jones²,

Pandor³

et al. 2007

Health Technol Assess

346

312

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“…Previous Canadian studies have indicated that, compared with no treatment or placebo, lipid lowering through statin therapy is a costeffective treatment for the secondary prevention of CV events (23,24) and may be cost-effective for primary prevention in selected patients (23). For use of statins for primary prvention, a study reported ICERs (25).…”

Section: Discussionmentioning

confidence: 99%

Economic evaluation of high-dose (80mg/day) atorvastatin treatment compared with standard-dose (20mg/day to 40mg/day) simvastatin treatment in Canada based on the Incremental Decrease in End-Points Through Aggressive Lipid-Lowering (IDEAL) trial

Wagner

Lindgren

Merikle

et al. 2009

Canadian Journal of Cardiology

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oBJECTIvEs: To assess the cost-effectiveness of high-dose atorvastatin versus standard-dose simvastatin treatment in patients with a history of MI from a Canadian societal perspective. METhoDs: In a within-trial analysis, end point-related events, resources used and productivity losses occurring during the IDEAL trial were aggregated by treatment arm on an intention-to-treat basis to calculate the incremental cost per event avoided. Additionally, quality-adjusted survival was projected using a lifetime Markov model. Transition probabilities, workdays lost, use of study medication and cardiovascular hospitalization rates were based on IDEAL trial data. Hospitalization, study medication and productivity costs were included. Probabilistic and deterministic sensitivity analyses were performed. rEsuLTs: Compared with standard-dose simvastatin, atorvastatin 80 mg led to 0.099 fewer events per patient and cost savings over 4.8 years of treatment. Over a lifetime horizon, atorvastatin 80 mg led to 0.023 qualityadjusted life years (QALYs) gained per patient at an incremental cost of $26,795/QALY gained. The incremental cost-effectiveness ratio remained below $50,000/QALY in 78% of 1000 simulations. Exclusion of indirect costs resulted in an incremental cost-effectiveness ratio of $38,834/QALY. Results were relatively sensitive to baseline age, but robust with respect to sex, baseline low-density lipoprotein cholesterol levels, diabetes status and hospitalization costs. ConCLusIon: From a Canadian societal perspective, high-dose atorvastatin is cost-effective compared with standard-dose simvastatin in patients with a previous MI.

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“…Physician fees, outpatient care, emergency services, and drug prescriptions also included in the model have been reported previously in detail. 18 American health care costs were derived from published reports. Hospital costs were based on the National Medicare Provider Analysis and Review data and the National Sample of the Health Care Costs and Utilization Project.…”

Section: Estimating Direct Health Care Costs Of Cardiovascular Diseasementioning

confidence: 99%

Treating Osteoarthritis With Cyclooxygenase-2–Specific Inhibitors

2005

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Abstract-Osteoarthritis and hypertension are highly prevalent among older Americans. Anti-inflammatory medications can destabilize blood pressure control. We estimated the decreased cardiovascular risk, premature mortality, and direct health care costs that could be avoided if blood pressure control is not destabilized among hypertensive Americans taking cyclooxygenase-2 (COX-2)-specific inhibitors for osteoarthritis. Data from the Third National Health and Nutrition Examination Survey (NHANES III) provided the distribution of cardiovascular risk factors among American adults with osteoarthritis and hypertension. The Cardiovascular Disease Life Expectancy Model was used to estimate the impact of a 2.26% increase in systolic blood pressure on the basis of results of a randomized trial comparing COX-2-specific inhibitors. A similar analysis was completed for American adults with osteoarthritis and untreated hypertension (Ն140/90 mm Hg). Among 7.3 million Americans with treated hypertension, maintaining blood pressure control would avoid Ͼ30 000 stroke deaths and 25 000 coronary deaths resulting in Ͼ449 000 person years of life saved and $1.4 billion in direct health care cost savings. When an additional 3.8 million Americans with untreated hypertension are considered, maintaining blood pressure control could prevent Ͼ47 000 stroke deaths, 39 000 coronary deaths, and result in 668 000 person years of life saved and Ͼ$2.4 billion in direct health care cost savings. We conclude that even a small increase in systolic blood pressure among hypertensive Americans with osteoarthritis may substantially increase the clinical and economic burden of cardiovascular disease. Maintaining blood pressure control may be associated with substantial benefits.

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Cost-effectiveness of 3-Hydroxy-3-Methylglutaryl–Coenzyme A Reductase Inhibitors in the Secondary Prevention of Cardiovascular Disease

Cited by 61 publications

References 30 publications

A systematic review and economic evaluation of statins for the prevention of coronary events

A systematic review and economic evaluation of statins for the prevention of coronary events

Economic evaluation of high-dose (80mg/day) atorvastatin treatment compared with standard-dose (20mg/day to 40mg/day) simvastatin treatment in Canada based on the Incremental Decrease in End-Points Through Aggressive Lipid-Lowering (IDEAL) trial

Treating Osteoarthritis With Cyclooxygenase-2–Specific Inhibitors

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