Cholesterol lowering and the use of healthcare resources. Results of the Scandinavian Simvastatin Survival Study.
BACKGROUND
Advances in the treatment of cardiovascular disease have increased costs; annual cardiovascular healthcare expenditure in the United States currently exceeds $100 billion. Physicians and third-party payers need to assess the economic impact of treatments that reduce cardiovascular morbidity and mortality.


RESULTS
The Scandinavian Simvastatin Survival Study is a randomized, double-blind, placebo-controlled trial in which simvastatin reduced the risk of death by 30% (P=.0003) over the median follow-up period of 5.4 years in patients with previous myocardial infarction or stable angina pectoris as a result of a 42% reduction in the risk of coronary deaths (P=.00001). In the present report, data prospectively collected from hospital admissions were analyzed to evaluate the impact of simvastatin on healthcare resource use and perform a cost-minimization analysis. In the placebo group (n=2223), there were 1905 hospitalizations (average duration, 7.9 days) for acute cardiovascular events or coronary revascularization procedures among 937 patients, whereas in the simvastatin group (n=2221), there were 1403 such hospitalizations (average duration, 7.1 days) among 720 patients (all differences, P<.0001). The corresponding number of hospital days was 15089 and 9951 in the two groups, respectively (34% reduction,P<.0001). In the United States, the resulting reduction in hospitalization costs over the 5.4 years of the trial would be $3872 per patient, reducing the effective cost of simvastatin by 88% to $0.28 per day.


CONCLUSIONS
In addition to reducing mortality and morbidity in coronary heart disease patients, simvastatin markedly reduces use of hospital services, thus offsetting most of its cost.
Pedersen
T R
TR
Cardiology Section, Medical Department, Aker Hospital, Oslo, Norway.
Kjekshus
J
J
Berg
K
K
Olsson
A G
AG
Wilhelmsen
L
L
Wedel
H
H
Pyörälä
K
K
Miettinen
T
T
Haghfelt
T
T
Faergeman
O
O
Thorgeirsson
G
G
Jönsson
B
B
Schwartz
J S
JS
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood*; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy* / Q000401:mortality; D004311:Double-Blind Method; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008148:Lovastatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D019821:Simvastatin
D000924:Anticholesteremic Agents; D002784:Cholesterol; D008148:Lovastatin; D019821:Simvastatin