A pharmacoeconomic evaluation of aggressive cholesterol lowering in Sweden.
OBJECTIVE
To estimate the short-term healthcare costs and incremental cost per event avoided, associated with aggressive atorvastatin treatment in patients with acute coronary syndrome in Sweden.


METHODS
The total expected 16-week healthcare costs per patient on atorvastatin 80 mg per day and placebo were compared using clinical outcomes data from The Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study and Swedish cost data sources. The incremental cost per event avoided was also assessed for. The clinical outcomes measured in this pharmacoeconomic analysis included: death, cardiac arrest, non-fatal myocardial infarction, fatal myocardial infarction, angina pectoris, non-fatal stroke, congestive heart failure, and surgical or percutaneous coronary revascularizations. All direct medical costs were taken into account.


RESULTS
The probability of the occurrence of an event was 40.4% per patient in the placebo cohort and 36.6% per patient in the atorvastatin cohort. The total expected cost per patient was SEK 17,887 (1950.21 euro) in the placebo group and SEK 18,465 (2013.06 euro) in the atorvastatin group, resulting in an incremental cost of SEK 578 (63.0137 euro) per patient. The cost per event avoided was SEK 15,076 (1643.64 euro). Sixty six percent of the cost of atorvastatin treatment was offset by the cost savings obtained through the reduction in the number of events in the atorvastatin group compared to the placebo group.


CONCLUSIONS
In Sweden, the clinical benefits of aggressive short-term atorvastatin treatment administered within a few days after acute coronary syndrome is associated with a substantial hospitalization cost offset secondary to the clinical benefits of atorvastatin.
Olsson
Anders
A
Department of Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Casciano
Roman
R
Stern
Lee
L
Svangren
Per
P
D000789:Angina, Unstable / Q000191:economics* / Q000517:prevention & control; D000924:Anticholesteremic Agents / Q000191:economics* / Q000627:therapeutic use; D000069059:Atorvastatin; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006538:Heptanoic Acids / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000191:economics* / Q000517:prevention & control; D011758:Pyrroles / Q000191:economics* / Q000627:therapeutic use; D012189:Retrospective Studies; D013548:Sweden; D013577:Syndrome; D013997:Time Factors; D016896:Treatment Outcome
D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin