Cost-Effectiveness of Statins for Primary Prevention in Newly Diagnosed Type 2 Diabetes Patients in the Netherlands

Abstract

using the UKPDS risk engine. Statin adherence was measured as pill days covered (PDC) in the IADB.nl pharmacy research database. Cost-effectiveness was measured in costs per quality-adjusted life-year (QALY) form the health carepayers' perspective. Results: For an average patient aged 60 at diagnosis, statin treatment was highly cost-effective at around € 2,300 per QALY. Favourable costeffectiveness was robust in sensitivity analysis. Differences in age and 10-year cardiovascular risk showed large differences in cost-effectiveness from more than € 100,000 per QALY to almost being cost saving. For the average patient aged 40 at diabetes diagnosis, statin treatment for primary prevention was not cost-effective. ConClusions: Despite the non-adherence levels observed in actual practice, statin treatment is cost-effective for primary prevention in patients newly diagnosed with type 2 diabetes. Due to large differences in cost-effectiveness according to different risk and age groups, the efficiency of the treatment could be increased by targeting patients with relatively higher cardiovascular risk and higher ages. PCV84 DeVeloPment of noVel ImagIng tests to seleCt PatIents for InDIVIDualIzeD theraPIes: are they Worth further InVestment?

Cost-effectiveness of statin treatment for primary prevention in conditions of real-world adherence – Estimates from the Finnish prescription register

“…Our study and the three recent studies [3,4,10] differ in many aspects. The time horizon in our study was 10 years as in the studies of Greving et al [3] and de Vries et al [10], whereas in the study by Lazar et al [4] the time horizon was 30 years.…”

“…The time horizon in our study was 10 years as in the studies of Greving et al [3] and de Vries et al [10], whereas in the study by Lazar et al [4] the time horizon was 30 years. The latter study [4] differed from the others also in that it modeled the statin effect by lowering the patient's LDL-levels which then affected the event risk.…”

“…Three recent studies have come to different conclusions about the cost-effectiveness of statin therapy and the sensitivity of costeffectiveness estimates with respect to statin adherence in primary prevention [3,4,10]. In the study of Greving et al, the base case result of the ICER of statin treatment was around V35,000 per QALY gained in the real-world adherence scenario [3].…”

“…Their cost-effectiveness estimates were insensitive to changes in statin adherence and an adherence level as low as 25% had only a minimal impact on statin cost-effectiveness. de Vries et al estimated that starting statin treatment at the time of diagnosis of type 2 diabetes is costeffective, but that there are large differences in cost-effectiveness according to patients' risk and age groups [10]. They reported adherence rates having a large effect on their results but chancing adherence rates did not change the conclusion of statin costeffectiveness.…”

“…Patients with poor adherence may experience worse outcomes and higher health care costs than patients with good adherence [13]. In previous studies where patient adherence has been taken into account, the results of the impact of patient adherence on the cost-effectiveness of statins in primary prevention have been conflicting [3,4,10].…”