[Economic aspects of drug therapy exemplified by pravastatin. A socioeconomic analysis of cholesterol synthase enzyme inhibition in coronary heart disease patients].
BACKGROUND
Decision makers in the field of health services are increasingly forced to identify and realise the grounds for spendings and savings. Therefore, preventive measures of cardiovascular diseases are becoming more and more scrutinized. The present analysis is answering the question: Is secondary preventive lipid-lowering therapy with a cholesterol-synthesis-enzyme-(CSE-)inhibitor in patients with manifest coronary heart disease cost-effective in comparison to other already proven medical interventions?


METHODS
The cost-effectiveness-analysis with the endpoint costs per life years saved had been chosen as a form of evaluation. The study is a retrospective analysis. The clinical data have been taken from the already published double blinded, randomised, placebo controlled PLAC-I- and -II-studies as well as from the PLAC-Meta-Analysis. The cost estimate (costs of myocardial infarction, stroke and cost therapy with pravastatin) were based on the perspective of the German statutory sick funds.


RESULTS
With the reduced probability of a fatal myocardial infarction or a stroke in the group treated with pravastatin there are cost offsets of DM 2,400. This figure is opposed to an additional expenditure of about DM 6,900, -for the CSE-inhibitor. The calculation of the effectiveness resulted in an additional life expectancy of 0.28 years in the pravastatin cohorts in comparison with the group treated with placebo over an observation period of 3 years. The costs per life year saved are approximately DM 16,000,-.


CONCLUSIONS
The preventive use of pravastatin in patients with coronary heart disease can be estimated as cost-effective as compared with other medical interventions.
Berger
K
K
Center of Pharmacoeconomics, School of Pharmacy, Milan.
Klose
G
G
Szucs
T D
TD
D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000191:economics*; D003327:Coronary Disease / Q000191:economics* / Q000401:mortality / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005858:Germany; D006801:Humans; D009313:National Health Programs / Q000191:economics; D017035:Pravastatin / Q000008:administration & dosage / Q000191:economics*; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate
D000924:Anticholesteremic Agents; D017035:Pravastatin