title: Are intensive lipid-lowering regimens an optimal economic strategy in patients with ACS? An acute and chronic perspective.
abstract: A literature review was conducted to identify studies exploring the cost-effectiveness of intensive lipid-lowering regimens compared with a generic low-dose statin for individuals with acute coronary syndrome. Three papers matched the inclusion criteria. All used a Markov model to represent the long-term clinical pathway; two were set in the UK and one was in the USA. While there were substantial differences in the effectiveness data, the definitions of the health states and the numbers of events predicted, all authors found that the intensive regimen was a cost-effective alternative compared with a generic lower dose statin. If the cost of atorvastatin reduces from GBP 368 pounds to 90 pounds per annum when the patent expires in 2011, atorvastatin 80 mg/day would be the most optimal treatment for this patient group. Simvastatin 80 mg/day should not be considered an alternative owing to an adverse safety profile and limited additional benefits.
authors.affiliation: School of Health & Related Research, University of Sheffield, Regent Court, Sheffield S1 4DA, UK. r.m.ara@sheffield.ac.uk
authors.forename: Roberta
authors.initials: R
authors.lastname: Ara
authors.forename: Rachid
authors.initials: R
authors.lastname: Rafia
authors.forename: Sue E
authors.initials: SE
authors.lastname: Ward
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Wierzbicki
authors.forename: Tim M
authors.initials: TM
authors.lastname: Reynolds
authors.forename: Angie
authors.initials: A
authors.lastname: Rees
authors.forename: Abdullah
authors.initials: A
authors.lastname: Pandor
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000191:economics; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D016568:Drugs, Generic / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D008390:Markov Chains; D006113:United Kingdom; D014481:United States
chemical_list: D016568:Drugs, Generic; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents