By the same authors

The cost-effectiveness of a new statin (rosuvastatin) in the UK NHS

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JournalInternational Journal of Clinical Practice
DatePublished - Nov 2003
Issue number9
Volume57
Number of pages9
Pages (from-to)792-800
Original languageEnglish

Abstract

Statins are central to the government's National Service Framework (NSF) for coronary heart disease (CHD). NHS spending on statins is currently about pound500 million per annum and rising at an annual rate of 30%. Although generally considered to be a cost-effective treatment for hyperlipidaemia and cardiovascular disease, given the high and rising expenditure on statins in the UK, there is a pressing need to ensure that the choice between available statins reflects cost-effectiveness considerations. A decision model was developed to establish the cost-effectiveness of treating new hypercholesterolaemic patients to UK and European target levels of blood total cholesterol (TC) and low density lipoprotein-cholesterol (LDL-C), using rosuvastatin, atorvastatin, simvastatin, pravastatin or fluvastatin. The model was used to estimate the proportion of patients reaching target and the associated costs over a one-year period from the perspective of the NHS. The effectiveness of the alternative statins were modelled using data from the Statin Therapies for Elevated Lipid Levels compared Across doses to Rosuvastatin (STELLAR) trial. Monte Carlo simulation was used to reflect uncertainty in the parameter estimates applied in the model. Rosuvastatin is demonstrated to dominate (i.e. lower costs and a higher number of patients treated to target) atorvastatin, simvastatin and pravastatin. Compared with fluvastatin, the incremental cost per additional patient to target (PTT) for rosuvastatin was pound24 using LDL-C and pound83 using TC. The probability that rosuvastatin is cost-effective exceeds 95%, provided the NHS is prepared to pay at least pound35 per PTT to achieve target LDL-C cholesterol levels (El 60 for TC). The analysis demonstrates rosuvastatin is more cost-effective than the other statins in achieving UK and European cholesterol targets.

    Research areas

  • CORONARY-HEART-DISEASE, HYPERCHOLESTEROLEMIC PATIENTS, EFFECTIVENESS MODELS, CHOLESTEROL LEVELS, DRUG-TREATMENT, SIMVASTATIN, ATORVASTATIN, PRAVASTATIN, TRIAL, RISK

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