title: Cost-effectiveness analysis of n-3 polyunsaturated fatty acids (PUFA) after myocardial infarction: results from Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto (GISSI)-Prevenzione Trial.
abstract: OBJECTIVE
  To estimate the cost effectiveness of treatment with n-3 polyunsaturated fatty acids (PUFA) for secondary prevention after myocardial infarction (MI).
  
  
  METHODS
  The cost-effectiveness analysis of n-3 PUFA treatment after MI was based on morbidity and mortality data and the use of resources obtained prospectively during the 3.5 year follow-up period of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto (GISSI)-Prevenzione study. The cost-effectiveness analysis took into account the incremental number of life-years gained and the incremental costs for hospital admissions, diagnostic tests and drugs, applying a 5% discount rate. The value for money of n-3 PUFA treatment was assessed using the cost-effectiveness ratio and the number needed to treat (NNT) approach.
  
  
  CONCLUSIONS
  Third-party payer.
  
  
  RESULTS
  The incremental cost-effectiveness ratio for n-3 PUFA in the basecase scenario was 24,603 euro (EUR, 1999 values) per life-year gained (95% confidence interval: 22,646 to 26,930). Sensitivity analysis included the analysis of extremes, producing estimates varying from EUR15,721 to EUR52,524 per life-year gained. 172 patients would need to be treated per year with n-3 PUFA, at an annual cost of EUR68,000, in order to save 1 patient. This is comparable with the NNT value, and associated annual cost for simvastatin, but less costly than that for pravastatin.
  
  
  CONCLUSIONS
  The cost effectiveness of long term treatment with n-3 PUFA is comparable with other drugs recently introduced in the routine care of secondary prevention after MI. Since the clinical benefit provided by n-3 PUFA is additive, this therapy should be added to the established routine practice, with additive costs.
authors.affiliation: Department of Cardiovascular Research, Istituto di Richerche Farmacologiche Mario Negri, Milano, Italy. franzosi@marionegri.it
authors.forename: M G
authors.initials: MG
authors.lastname: Franzosi
authors.forename: M
authors.initials: M
authors.lastname: Brunetti
authors.forename: R
authors.initials: R
authors.lastname: Marchioli
authors.forename: R M
authors.initials: RM
authors.lastname: Marfisi
authors.forename: G
authors.initials: G
authors.lastname: Tognoni
authors.forename: F
authors.initials: F
authors.lastname: Valagussa
mesh_terms: D003362:Cost-Benefit Analysis; D017850:Economics, Pharmaceutical; D015525:Fatty Acids, Omega-3 / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007558:Italy; D009203:Myocardial Infarction / Q000191:economics* / Q000517:prevention & control; D011446:Prospective Studies
chemical_list: D015525:Fatty Acids, Omega-3