Cost-effectiveness of lovastatin - Tips From Other Journals

Date: August, 1991

Some cost-effectiveness analyses have questioned whether current recommendations for drug treatment in persons with elevated cholesterol levels are affordable. Goldman and colleagues employed a computer-simulated model (Coronary Heart Disease Policy Model) to evaluate the cost-effectiveness of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (such as lovastatin) in the primary and secondary prevention of coronary artery disease.

The computer model estimated the risk factor-specific annual incidence of coronary artery disease and the risk of recurrent coronary events in persons with preexisting coronary artery disease (secondary prevention). Using this model, a daily dose of 20 mg of lovastatin was estimated to save lives and reduce the overall costs of coronary artery disease in young men with cholesterol levels above 250 mg per dL (6.45 mmol per L). Favorable cost effectiveness ratios were also found in women, except young women with cholesterol levels below 250 mg per dL (6.45 mmol per L).

In persons without existing coronary artery disease (primary prevention), favorable cost-effectiveness ratios were found only in selected subgroups, based on cholesterol levels and other risk factors.

The authors conclude that national recommendations for drug treatment of patients with known coronary artery disease are not as aggressive as they could be. Recommendations for primary prevention should consider the cost of medication, as well as the risk factor profile of the individual patient. (JAMA, March 6, 1991, vol. 265, p. 1145.)

COPYRIGHT 1991 American Academy of Family PhysiciansCOPYRIGHT 2004 Gale Group

 
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