title: Effect of simvastatin treatment on cardiovascular resource utilization in impaired fasting glucose and diabetes. Findings from the Scandinavian Simvastatin Survival Study.
abstract: OBJECTIVE
  The Scandinavian Simvastatin Survival Study showed that simvastatin treatment reduced cardiovascular events in hypercholesterolemic subjects with coronary heart disease. The clinical benefits of therapy were similar in all three subgroups: normal fasting glucose (NFG, n = 3,237), impaired fasting glucose (IFG, n = 678), and diabetes (n = 483). This analysis compared the costs of simvastatin treatment with the costs of cardiovascular disease-related hospitalizations in the three subgroups.
  
  
  METHODS
  The cost of simvastatin treatment was defined as the average retail price and the cost of drug safety monitoring and adverse experiences. The costs of cardiovascular disease-related hospitalizations were determined by actual rates of hospitalization and 1995 MEDSTAT diagnosis-related group costs.
  
  
  RESULTS
  Within trial, simvastatin treatment cost approximately $6,000 per patient. Simvastatin treatment reduced cardiovascular disease-related hospitalizations by 23% in NFG (P = 0.001), 30% in IFG (P = 0.015), and 40% in diabetic subjects (P = 0.007) within trial (median follow-up of 5.4 years). Average length of stay was reduced by 2.4 days in diabetic subjects (P = 0.021). Total cardiovascular disease-related hospital days were reduced by 28% (P < 0.001) in NFG, 38% (P = 0.005) in IFG, and 55% (P < 0.001) in diabetic subjects. For NFG subjects, simvastatin reduced the average cost of cardiovascular disease-related hospitalizations by $3,585, which offset 60% of the cost of simvastatin therapy. For IFG subjects, average cardiovascular disease-related hospitalization costs were reduced by $4,478, which offset 74% of the drug cost. For diabetic subjects, there was a net cost savings of $1,801 per subject within trial.
  
  
  CONCLUSIONS
  Simvastatin significantly reduced cardiovascular disease-related hospitalizations and total hospital days for all three groups and significantly reduced length of stay for the diabetic group in addition to providing significant clinical benefits. The benefits were greatest in the diabetic group, with estimated cost savings within trial from simvastatin treatment.
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0354, USA.
authors.forename: W H
authors.initials: WH
authors.lastname: Herman
authors.forename: C M
authors.initials: CM
authors.lastname: Alexander
authors.forename: J R
authors.initials: JR
authors.lastname: Cook
authors.forename: S J
authors.initials: SJ
authors.lastname: Boccuzzi
authors.forename: T A
authors.initials: TA
authors.lastname: Musliner
authors.forename: T R
authors.initials: TR
authors.lastname: Pedersen
authors.forename: J
authors.initials: J
authors.lastname: Kjekshus
authors.forename: K
authors.initials: K
authors.lastname: Pyörälä
mesh_terms: D002318:Cardiovascular Diseases / Q000191:economics / Q000401:mortality / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003925:Diabetic Angiopathies / Q000191:economics / Q000401:mortality / Q000517:prevention & control*; D004311:Double-Blind Method; D005215:Fasting / Q000502:physiology*; D005260:Female; D018149:Glucose Intolerance; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012537:Scandinavian and Nordic Countries; D019821:Simvastatin / Q000191:economics / Q000627:therapeutic use*; D015996:Survival Rate
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin