Cost-effectiveness of simvastatin in people at different levels of vascular disease risk: economic analysis of a randomised trial in 20,536 individuals

Heart Protection Study Collaborative Group (2005) Cost-effectiveness of simvastatin in people at different levels of vascular disease risk: economic analysis of a randomised trial in 20,536 individuals. Lancet, 365 (9473). pp. 1779-1780. ISSN 1474-547X

Full text not available from this repository.

Abstract

Background: Statin therapy reduces the rates of heart attack, stroke, and revascularisation among a wide range of individuals. Reliable assessment of its cost-effectiveness in different circumstances is needed. Methods: 20 536 adults (aged 40–80 years) with vascular disease or diabetes were randomly allocated 40 mg simvastatin daily (10 269) or placebo (10 267) for an average of 5 years. Comparisons were made of hospitalisation and statin costs (2001 UK prices) during the scheduled treatment period between all simvastatin-allocated versus all placebo-allocated participants. Cost-effectiveness was estimated among different categories of participant. Findings: Allocation to simvastatin was associated with a highly significant 22% (95% CI 16–27; p<0·0001) proportional reduction in hospitalisation costs for all vascular events, with similar proportional reductions in every subcategory of participant studied. During an average of 5 years, estimated absolute reductions in vascular event costs per person allocated 40 mg simvastatin daily ranged from UK£847 (SE 137) in the highest risk quintile studied to £264 (48) in the lowest. Mean excess cost of statin therapy among participants allocated simvastatin was £1497 (8), with similar absolute increases in every subcategory. Costs of preventing a major vascular event with 40 mg simvastatin daily ranged from £4500 (95% CI 2300–7400) among participants with a 42% 5-year major vascular event rate to £31 100 (22 900–42 500) among those with a 12% rate (corresponding to 5-year major coronary event rates of 22% and 4%, respectively). Interpretation: Statin therapy is cost effective for a wider range of individuals with vascular disease or diabetes than previously recognised (particularly with lower-priced generics). It would be appropriate to consider reducing the estimated level of vascular event risk at which statin therapy is recommended.

Item Type:	Article
Faculty \ School:	Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User:	EPrints Services
Date Deposited:	25 Nov 2010 11:13
Last Modified:	02 Feb 2024 01:51
URI:	https://ueaeprints.uea.ac.uk/id/eprint/15416
DOI:	10.1016/S0140-6736(05)63014-0

Actions (login required)

View Item