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.

Taylor, Douglas C. A.; Pandya, Ankur; Thompson, David; Chu, Paula; Graff, Jennifer; Shepherd, James; Wenger, Nanette; Greten, Heiner; Carmena, Rafael; Drummond, Michael; Weinstein, Milton C.

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 € 9,500, € 21,000, and € 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.

UNITED Kingdom; SPAIN; CARDIOVASCULAR disease prevention; CLINICAL trials; COST effectiveness; MARKOV processes

European Journal of Health Economics, 2009, Vol 10, Issue 3, p255

1618-7598

Academic Journal

10.1007/s10198-008-0126-1