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Previous Volume 336:332-336 January 30, 1997 Number 5 Next

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ABSTRACT

Background The Scandinavian Simvastatin Survival Study (4S) showed that lowering cholesterol levels with simvastatin reduces mortality and morbidity in patients with angina pectoris or previous acute myocardial infarction. Before the widespread use of cholesterol-lowering drugs in such patients is recommended, its cost effectiveness should be demonstrated. We estimated the cost effectiveness of simvastatin treatment to lower cholesterol levels in relation to the age, sex, and cholesterol level before treatment of patients with coronary heart disease.

Methods We estimated the cost per year of life gained with simvastatin therapy. To model the increased life expectancy, hazard functions from 4S were used. The costs studied included those of the intervention and the direct and indirect costs associated with morbidity from coronary causes. We prepared separate estimates for men and women at various ages (from 35 to 70 years) and total cholesterol levels before treatment (213 to 309 mg per deciliter).

Results In the analysis limited to direct costs, the cost of each year of life gained ranged from $3,800 for 70-year-old men with 309 mg of cholesterol per deciliter to $27,400 for 35-year-old women with 213 mg of cholesterol per deciliter. When we included indirect costs, the results ranged from a savings in the youngest patients to a cost of $13,300 per year of life gained in 70-year-old women with 213 mg of cholesterol per deciliter.

Conclusions In patients with coronary heart disease, simvastatin therapy is cost effective among both men and women at the ages and cholesterol levels studied.

Source Information

From the Center for Health Economics, Stockholm School of Economics, Stockholm, Sweden (M.J., B.J.); the Section of Cardiology, University of Oslo, Rikshospitalet, Oslo, Norway (J.K.); the Department of Internal Medicine, Faculty of Health Sciences, Linköping, Sweden (A.G.O.); the Cardiology Section, Medical Department, Aker Hospital, Oslo, Norway (T.R.P.); and the Nordic School of Public Health, Gothenburg, Sweden (H.W.).

Address reprint requests to Dr. Johannesson at the Center for Health Economics, Stockholm School of Economics, Box 6501, S-113 83 Stockholm, Sweden.

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