Cost-effectiveness of atorvastatin for the prevention of coronary and stroke events: an economic analysis of the Anglo-Scandinavian Cardiac Outcomes Trial--lipid-lowering arm (ASCOT-LLA).
BACKGROUND
The aim of this study is to assess the cost-effectiveness of the lipid-lowering arm of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-LLA) where patients from seven countries with hypertension and no history of coronary heart disease (CHD) were randomized to receive 10 mg atorvastatin or placebo.


METHODS
Economic analysis of a randomized controlled trial.


METHODS
Data on resource use were aggregated for all patients during the entire trial period (median 3.3 years) and multiplied with unit costs for Sweden and the UK. The total number of cardiovascular events and procedures avoided was used as the measure of effectiveness.


RESULTS
Patients treated with atorvastatin had an additional net costs of 449 euro (4114 SEK) in Sweden and 414 euro (260 pounds sterling) in the UK, but fewer events per patient (0.097 compared to 0.132). The incremental cost-effectiveness ratios were 12673 euro (116119 SEK) and 11693 euro (7349 pounds sterling) per event avoided.


CONCLUSIONS
Based on comparisons with the WOSCOPS and 4S studies, atorvastatin at 10 mg to treat patients as in the ASCOT study, appears to be a cost-effective strategy.
Lindgren
Peter
P
Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden.
Buxton
Martin
M
Kahan
Thomas
T
Poulter
Neil R
NR
Dahlöf
Björn
B
Sever
Peter S
PS
Wedel
Hans
H
Jönsson
Bengt
B
D000069059:Atorvastatin; D003324:Coronary Artery Disease / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D016527:Drug Costs / Q000706:statistics & numerical data*; D006538:Heptanoic Acids / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D010919:Placebos; D011758:Pyrroles / Q000191:economics* / Q000627:therapeutic use*; D020521:Stroke / Q000517:prevention & control*; D016896:Treatment Outcome
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010919:Placebos; D011758:Pyrroles; D000069059:Atorvastatin