Cost-effectiveness analysis of statins for the treatment of hospitalized COVID-19 patients

Abstract

Background: A recent systematic review and meta-analysis reporting on thirteen published cohorts investigating 110,078 patients demonstrated that patients who were administered statins after their COVID-19 diagnosis and hospitalization were had a lower risk of mortality. While these findings are encouraging, given competing COVID-19 treatment approaches, it is unclear if statin use should be prioritized and if its use is a cost-effective treatment options for hospitalized COVID-19 patients. In this study, we report on a cost-effectiveness analysis of statin-containing treatment regimens for hospitalized COVID-19 patients. Methods: A Markov model was used to compare statin use and no statin use among hospitalized COVID-19 patients from a United States healthcare perspective. The cycle length was one week, with a time horizon of 4 weeks. A Monte Carlo microsimulation with 20,000 samples were used. All analyses were conducted using TreeAge Pro Healthcare Version 2021 R1.1.

Lessons Learned from Model-based Economic Evaluations of COVID-19 Drug Treatments Under Pandemic Circumstances: Results from a Systematic Review

“…All seven studies with a societal perspective included productivity loss as the only indirect cost type in the analysis. One study did not report any sensitivity analysis, although the use of probability distributions was reported to account for potential variation in measured effectiveness [ 25 ]. All other studies applied and reported one or more uncertainty measures to assess the level of confidence regarding the results of the evaluation.…”

“…Three types of differentiation were identified, namely: level of respiratory support, level of care management (i.e., ICU versus non-ICU) and symptom levels (mild, moderate, severe). Nine (39.1%) studies grouped on respiratory support [ 22 , 28 – 35 ], six (26.1%) on level of care management [ 25 , 27 , 36 – 39 ], seven (30.4%) on the both respiratory support and level of care management [ 24 , 26 , 40 – 44 ] and one (4.3%) on symptoms [ 45 ]. Four studies did not apply any differentiation during hospitalisation (14.8%).…”

“…Six studies using a state-transition model included more than one hospitalisation state and allowed for transition between those health states. In the models designed by Chow et al and Jiang et al, patients could shift from non-ICU to ICU and vice versa [ 25 , 45 ]. The stochastic compartmental transmission model used by Jo et al included a general ward compartment before and after ICU treatment [ 38 ].…”

Impact of P-selectin–PSGL-1 Axis on Platelet-Endothelium-Leukocyte Interactions in Fatal COVID-19

“…Several studies have demonstrated that statin use in patients hospitalized with COVID-19 is associated with lower inpatient mortality. 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 . The explanation for this finding could be that statins are known as potent P-selectin inhibitors.…”

Statin Therapy to Improve Outcome of COVID-19 Patients: Useful or Not Useful?

“…A causal relationship between statin-related reduced risk of COVID-19 hospitalization and HMG-CoA reductase inhibition was suggested by Mendelian randomization studies showing an association between a higher HMG-CoA reductase expression or mediated LDL-cholesterol and a higher risk of hospitalization (OR, 1.38; 95% CI, 1.06–1.81; p = 0.019 and OR, 1.32; 95% CI, 1.00–1.74; p = 0.049, respectively) [ 39 ]. A medico-economic study established that in hospitalized COVID-19 patients, treatment with statins was both cheaper (USD 31,623 ± 20,331 versus USD 33,218 ± 25,440) and more effective (mean utility value, 1.70 ± 1.96 versus 1.71 ± 1.00) than treatment without statins [ 40 ].…”