title: Cost-effectiveness of intensive atorvastatin therapy in secondary cardiovascular prevention in the United Kingdom, Spain, and Germany, based on the Treating to New Targets study.
abstract: The Treating to New Targets (TNT) clinical trial found that intensive 80 mg atorvastatin (A80) treatment reduced cardiovascular events by 22% when compared to 10 mg atorvastatin (A10) treatment. We evaluated the cost-effectiveness of intensive A80 vs A10 treatment in the United Kingdom (UK), Spain, and Germany. A lifetime Markov model was developed to predict cardiovascular disease-related events, costs, survival, and quality-adjusted life-years (QALYs). Treatment-specific event probabilities were estimated from the TNT clinical trial. Post-event survival, health-related quality of life, and country-specific medical-care costs were estimated using published sources. Intensive treatment with A80 increased both the per-patient QALYs and corresponding costs of care, when compared to the A10 treatment, in all three countries. The incremental cost per QALY gained was <euro> 9,500, <euro> 21,000, and <euro> 15,000 in the UK, Spain, and Germany, respectively. Intensive A80 treatment is estimated to be cost-effective when compared to A10 treatment in secondary cardiovascular prevention.
authors.affiliation: i3 Innovus, 10 Cabot Road, Suite 304, Medford, MA 02155, USA. douglas.taylor@i3innovus.com
authors.forename: Douglas C A
authors.initials: DC
authors.lastname: Taylor
authors.forename: Ankur
authors.initials: A
authors.lastname: Pandya
authors.forename: David
authors.initials: D
authors.lastname: Thompson
authors.forename: Paula
authors.initials: P
authors.lastname: Chu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Graff
authors.forename: James
authors.initials: J
authors.lastname: Shepherd
authors.forename: Nanette
authors.initials: N
authors.lastname: Wenger
authors.forename: Heiner
authors.initials: H
authors.lastname: Greten
authors.forename: Rafael
authors.initials: R
authors.lastname: Carmena
authors.forename: Michael
authors.initials: M
authors.lastname: Drummond
authors.forename: Milton C
authors.initials: MC
authors.lastname: Weinstein
mesh_terms: D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D004305:Dose-Response Relationship, Drug; D005060:Europe; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D006801:Humans; D008390:Markov Chains; D011758:Pyrroles / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use*; D019057:Quality-Adjusted Life Years
chemical_list: D000924:Anticholesteremic Agents; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin