Cost of Treating to a Modified European Atherosclerosis Society LDL-C Target

Smith, Dean G.; Leslie, S; Szucs, Thomas D.; McBride, Scott; Campbell, L. M.; Calvo, Carlos; Lecerf, J. M.; Fellin, Renato

doi:10.2165/00044011-199917030-00003

Cited by 23 publications

(11 citation statements)

References 34 publications

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“…A number of strategies to improve the use of lipid-lowering drugs and increase achievement of NCEP LDL goals have been reported. [26][27][28][29][30] The use of more effective statins, such as atorvastatin and rosuvastatin, and dosage titration of statins have increased the numbers of patients achieving their LDL targets. Enrollment of patients in specialized lipid clinics and the use of standardized treatment protocols also have increased the use and effectiveness of lipidlowering therapy.…”

Section: Discussionmentioning

confidence: 99%

Cost of a Pharmacist‐Directed Intervention to Increase Treatment of Hypercholesterolemia

2004

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A relatively simple physician-prompting intervention involving patients with CHD significantly improved the use of lipid testing and statin therapy. Improved use of statins was associated with better CHD outcomes. As a result, the physician-prompting intervention was associated with cost savings. This intervention should be implemented for patients with CHD discharged after hospitalization for an ischemic event.

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Section: Discussionmentioning

confidence: 99%

Cost of a Pharmacist‐Directed Intervention to Increase Treatment of Hypercholesterolemia

2004

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“…In a statin formulary conversion programme, switching has been reported to reduce costs by US$115/patient treatment‐year, in addition to helping more patients to attain recommended lipid levels (50). Additional studies have demonstrated that the most efficacious statins are also the most cost‐effective in terms of reducing LDL‐C and helping patients to achieve recommended LDL‐C goals (51–54). Recently, an economic model was constructed to estimate the average drug cost and incremental drug cost per patient achieving National Service Framework (NSF) target levels in the UK (55).…”

Section: Getting Patients To Goal – Titratecombine or Switchmentioning

confidence: 99%

Improving lipid management - to titrate, combine or switch

Schuster

2004

International Journal of Clinical Practice

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Despite the benefits of statin therapy, cholesterol management remains suboptimal and many patients do not achieve their recommended low-density lipoprotein cholesterol (LDL-C) goals. The use of insufficient doses, limited drug effectiveness and poor patient compliance may contribute to the treatment gap. Options for improving lipid management include dose titration, combination therapy or prescribing a more efficacious statin. LDL-C reductions are generally modest when patients' current statin dose is titrated, and there may be an increased potential for adverse effects. Combining statin therapy with another lipid-modifying agent can provide additional LDL-C reductions, but cost, tolerability and compliance should be considered. In general, switching to a more efficacious statin is a cost-effective way of enabling more patients to achieve recommended targets without increasing dosages. When considering the options available, physicians should balance efficacy, cost and safety to enable more patients to attain LDL-C goals and achieve greater therapeutic gain from statin treatment.

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“…Patients who exceed the UK and European target TC/LDL levels are initially assigned treatment with one of the five licensed statins at the lowest licensed dose. The base‐case model is structured as a decision tree (Figure 1), and is similar in structure to other previously published statin cost‐effectiveness models 17,18 . The model allows for flexibility in both the treatment pattern assumed as well as input parameters.…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies have used decision analytic approaches to evaluate the cost‐effectiveness of alternative statins to achieve target cholesterol reductions 15–20 . Two of these studies considered TC and LDL‐C cholesterol targets 15 and LDL‐C targets only 16 from a UK perspective.…”

Section: Introductionmentioning

confidence: 99%

The Cost‐effectiveness of a New Statin (Rosuvastatin) in the Uk NHS

Palmer

Brady

Ratcliffe

2003

Int J Clinical Practice

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SUMMARYStatins are central to the government's National Service Framework (NSF) for coronary heart disease (CHD). NHS spending on statins is currently about £500 million per annum and rising at an annual rate of 30%. Although generally considered to be a cost‐effective treatment for hyperlipidaemia and cardiovascular disease, given the high and rising expenditure on statins in the UK, there is a pressing need to ensure that the choice between available statins reflects cost‐effectiveness considerations. A decision model was developed to establish the cost‐effectiveness of treating new hypercholesterolaemic patients to UK and European target levels of blood total cholesterol (TC) and low density lipoprotein‐cholesterol (LDL‐C), using rosuvastatin, atorvastatin, simvastatin, pravastatin or fluvastatin. The model was used to estimate the proportion of patients reaching target and the associated costs over a one‐year period from the perspective of the NHS. The effectiveness of the alternative statins were modelled using data from the Statin Therapies for Elevated Lipid Levels compared Across doses to Rosuvastatin (STELLAR) trial. Monte Carlo simulation was used to reflect uncertainty in the parameter estimates applied in the model. Rosuvastatin is demonstrated to dominate (i.e. lower costs and a higher number of patients treated to target) atorvastatin, simvastatin and pravastatin. Compared with fluvastatin, the incremental cost per additional patient to target (PTT) for rosuvastatin was £24 using LDL‐C and £83 using TC. The probability that rosuvastatin is cost‐effective exceeds 95%, provided the NHS is prepared to pay at least £35 per PTT to achieve target LDL‐C cholesterol levels (£160 for TC). The analysis demonstrates rosuvastatin is more cost‐effective than the other statins in achieving UK and European cholesterol targets.

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Cost of Treating to a Modified European Atherosclerosis Society LDL-C Target

Cited by 23 publications

References 34 publications

Cost of a Pharmacist‐Directed Intervention to Increase Treatment of Hypercholesterolemia

Cost of a Pharmacist‐Directed Intervention to Increase Treatment of Hypercholesterolemia

Improving lipid management - to titrate, combine or switch

The Cost‐effectiveness of a New Statin (Rosuvastatin) in the Uk NHS

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