Abstract | BACKGROUND: OBJECTIVE: METHODS: A post hoc subgroup analysis of patients with diabetes from the LIPS was used to estimate the effectiveness of fluvastatin in reducing myocardial infarction, revascularization, and cardiac death. A probabilistic Markov model was developed using United Kingdom resource and cost data to estimate the additional costs and quality-adjusted life-years (QALYs) gained over 10 years from the perspective of the British National Health Service. The model contained 6 health states, and the transition probabilities were derived from the LIPS data. Crossover from fluvastatin to other lipid-lowering drugs, withdrawal from fluvastatin, and the use of lipid-lowering drugs in the control group were included. RESULTS: In the subgroup of 202 patients with diabetes in the LIPS trial, 18 (15.0%) of 120 fluastatin patients and 21 (25.6%) of 82 control participants were insulin dependent (P = NS). Compared with the control group, patients treated with fluvastatin can expect to gain an additional mean (SD) of 0.196 (0.139) QALY per patient over 10 years (P < 0.001) and will cost the health service an additional mean (SD) of 10 pounds ( 448 pounds) (P = NS) (mean [SD] US $16 [$689]). The additional cost per QALY gained was 51 pounds (US $78). The key determinants of cost-effectiveness included the probabilities of repeat interventions, cardiac death, the cost of fluvastatin, and the time horizon used for the evaluation. CONCLUSION:
Fluvastatin was an economically efficient treatment to prevent MACEs in these patients with diabetes undergoing PCI.
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Authors | Paul A Scuffham, Stephen Chaplin |
Journal | Clinical therapeutics
(Clin Ther)
Vol. 27
Issue 9
Pg. 1467-77
(Sep 2005)
ISSN: 0149-2918 [Print] United States |
PMID | 16291420
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Fatty Acids, Monounsaturated
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
- Indoles
- Fluvastatin
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Topics |
- Angioplasty, Balloon, Coronary
- Cost-Benefit Analysis
- Diabetes Complications
(economics, prevention & control, therapy)
- Fatty Acids, Monounsaturated
(economics, therapeutic use)
- Fluvastatin
- Heart Diseases
(economics, prevention & control, therapy)
- Humans
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
(economics, therapeutic use)
- Indoles
(economics, therapeutic use)
- Markov Chains
- Models, Economic
- Multicenter Studies as Topic
- Multivariate Analysis
- Quality-Adjusted Life Years
- Randomized Controlled Trials as Topic
- United Kingdom
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