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.
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.
Franzosi
M G
MG
Department of Cardiovascular Research, Istituto di Richerche Farmacologiche Mario Negri, Milano, Italy. franzosi@marionegri.it
Brunetti
M
M
Marchioli
R
R
Marfisi
R M
RM
Tognoni
G
G
Valagussa
F
F
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
D015525:Fatty Acids, Omega-3