Coronary artery disease: hypercholesterolaemia: simvastatin therapy is cost-effective

Clinical bottom line (level 1b)

  1. Simvastatin therapy for patients with angina or a myocardial infarction and elevated cholesterol levels is cost-effective.
Johannesson et al: New England Journal of Medicine 1997; 336 (5): 332-336
Expires March 2003

The study

cost-effectiveness analysis
Setting: acute hospitals, Sweden

A Markow decision analysis based on data taken from a randomised controlled trial of patients with a history of angina or myocardial infarction and cholesterol levels 5.5 to 8.0 mmol/l who received simvastatin or placebo.

  • Viewpoint: National Health Service or HMO
  • Benefit assessment: reduction in morbidity and mortality
  • Resources and costs: Costs included indirect costs and were taken from the cost-accounting systems of four Swedish hospitals; costs and numbers of years of life gained were discounted by 5%
  • Sensitivity analysis: Costs, treatment effectivness and quality of life were varied.

    • The evidence

    intervention cost
    cost for men per year gained US (1995) $1600
    cost for women per year gain US (1995) $5100

    Effect of sensitivity analysis: Costs for men ranged from savings to $9300 per year saved and for women from $100 to $18 500 per year saved.

    Citation

    1. Johannesson M, Jonsson B, Kjekshus J, et al: cost effectiveness of simvastatin treatment to lower cholesterol levels in patients with coronary heart disease. New England Journal of Medicine 1997; 336 (5): 332-336
    Search Terms: ?
    Contributor: Chris Ball and Clare Wotton, February 2000
    Reviewer: Dwight Peretz

    Clinical Question.
    Patient angina or MI and elevated cholesterol
    Intervention or Exposure simvastatin
    Outcome cost-effectiveness