Long-term impact on healthcare resource utilization of statin treatment, and its cost effectiveness in the primary prevention of cardiovascular disease: a record linkage study
| Autor: | Ian Ford, Alex McConnachie, Chris J. Packard, Laura Marchbank, Andrew Walker, Michele Robertson, Julie Peacock, Stuart M. Cobbe |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Cardiovascular outcomes Prevention and Epidemiology Cost effectiveness Cost-Benefit Analysis Myocardial Infarction 030204 cardiovascular system & hematology Lower risk State Medicine 03 medical and health sciences Record linkage 0302 clinical medicine Quality of life Clinical Research Medicine Humans 030212 general & internal medicine Myocardial infarction Stroke Pravastatin Primary prevention business.industry Middle Aged medicine.disease 3. Good health Quality-adjusted life year Hospitalization Treatment Outcome Cardiovascular Diseases Emergency medicine Physical therapy Health Resources Quality-Adjusted Life Years Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | European Heart Journal |
| ISSN: | 1522-9645 0195-668X |
| Popis: | Aims: To assess the impact on healthcare resource utilization, costs, and quality of life over 15 years from 5 years of statin use in men without a history of myocardial infarction in the West of Scotland Coronary Prevention Study (WOSCOPS).\ud \ud Methods: Six thousand five hundred and ninety-five participants aged 45–54 years were randomized to 5 years treatment with pravastatin (40 mg) or placebo. Linkage to routinely collected health records extended follow-up for secondary healthcare resource utilization to 15 years. The following new results are reported: cause-specific first and recurrent cardiovascular hospital admissions including myocardial infarction, heart failure, stroke, coronary revascularization and angiography; non-cardiovascular hospitalization; days in hospital; quality-adjusted life years (QALYs); costs of pravastatin treatment, treatment safety monitoring, and hospital admissions.\ud \ud Results: Five years treatment of 1000 patients with pravastatin (40 mg/day) saved the NHS £710 000 (P < 0.001), including the cost of pravastatin and lipid and safety monitoring, and gained 136 QALYs (P = 0.017) over the 15-year period. Benefits per 1000 subjects, attributable to prevention of cardiovascular events, included 163 fewer admissions and a saving of 1836 days in hospital, with fewer admissions for myocardial infarction, stroke, heart failure and coronary revascularization. There was no excess in non-cardiovascular admissions or costs (or in admissions associated with diabetes or its complications) and no evidence of heterogeneity of effect over sub-groups defined by baseline cardiovascular risk.\ud Conclusion: Five years' primary prevention treatment of middle-aged men with a statin significantly reduces healthcare resource utilization, is cost saving, and increases QALYs. Treatment of even younger, lower risk individuals is likely to be cost-effective. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|