[Cost-effectiveness analysis of the use of atorvastatin in patients with type 2 diabetes mellitus: a pharmacoeconomic model of the CARDS study].
OBJECTIVE
To perform a cost-effectiveness analysis of the use of Atorvastatin 10 mg in the primary prevention of cardiovascular disease in patients with type 2 diabetes (DM2).


METHODS
A deterministic and retrospective model by a decision analysis based on CARDS study (Collaborative Atorvastatin Diabetes Study) was performed. In the CARDS study, a significant reduction in cardiovascular morbimortality by the use of Atorvastatin 10 mg versus placebo (5.8 vs. 9.0%, p=0.001) in DM2 patients with an additional condition, had previously been demonstrated. In the present cost-effectiveness analysis, effectiveness units were life years gained (LYG) and quality adjusted life years (QALY), obtained from differences in morbimortality and life expectancy in DM2 patients, with and without previous cardiovascular events. Costs of the evaluated alternatives were obtained from the CARDS results.


RESULTS
Incremental cost-effectiveness ratio of using Atorvastin 10 mg versus placebo was 5,886 euro per LYG and 8,046 euro per QALY. Sensitivity analyses confirmed the model stability.


CONCLUSIONS
In the primary prevention of the cardiovascular disease in type 2 diabetic patients, the use of Atorvastatin 10 mg is cost-effective, with a cost per LYG and per QALY below that of other alternatives widely used in the Spanish National Health System, and also below a value considered as a reasonable threshold for our country, which might unofficialy be around 30,000 euro/ QALY.
Fernández de Bobadilla
J
J
Investigación de Resultados en Salud y Farmacoeconomía, Unidad Médica, Pfizer I+D+i Madrid.
López de Sa
E
E
Alonso Troncoso
I
I
Moreno Gómez
R
R
Rubio-Terrés
C
C
Soto Alvarez
J
J
D000328:Adult; D000368:Aged; D000069059:Atorvastatin; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006538:Heptanoic Acids / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D008875:Middle Aged; D011758:Pyrroles / Q000191:economics* / Q000627:therapeutic use*; D012189:Retrospective Studies
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin