Scott D. Ramsey (Fred Hutchinson Cancer Research Center, Seattle, Washington, USA) Lauren D. Clarke (Cornerstone NW, Lynden, Washington, USA) Craig S. Roberts (Global Outcomes Research, Pfizer Inc., New York, New York, USA) Sean D. Sullivan (Fred Hutchinson Cancer Research Center, Seattle, Washington, USA) Scott J. Johnson (Analysis Group Inc., Boston, Massachusetts, USA) Larry Z. Liu (Global Outcomes Research, Pfizer Inc., New York, New York, USA)
Abstract
Objective: The CARDS trial, a multicentre, randomized, controlled trial, found that atorvastatin 10 mg/day for patients with type 2 diabetes mellitus and normal low-density lipoprotein (LDL)-cholesterol significantly reduced cardiovascular (CV) events, including stroke. We estimated the cost effectiveness of atorvastatin as primary prevention against CV disease from the short-term and lifetime US payer perspectives. Research design and methods: We constructed a decision analytic (Markov) model to evaluate long-term costs and outcomes for atorvastatin 10 mg/day versus no HMG-CoA reductase inhibitor (statin) therapy for patients with type 2 diabetes and no history of a CV event. CV event rates and survival were based on risk equations calibrated to CARDS and applied to a US type 2 diabetes population; the atorvastatin effect on CV events was based on hazard ratios from CARDS; direct medical care costs were based on US treatment patterns and published costs analyses of patients with diabetes. Costs were valued in $US, year 2005 values; costs and benefits were discounted at 3% per annum. Results: Within the time horizon of the trial (5 years), the cost effectiveness of atorvastatin was $US137 Conclusions: For patients with type 2 diabetes and one additional risk factor for CV disease, normal LDL-cholesterol and no history of a CV event, primary prevention with atorvastatin appears to be cost saving and improve outcomes over 25 years, although it is costly from a short-term US payer perspective. From both a medical and an economic viewpoint, primary prevention is desirable in this patient population.
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Article provided by Wolters Kluwer Health | Adis in its journal PharmacoEconomics.
Volume (Year): 26 (2008) Issue (Month): 4 () Pages: 329-339 Download reference. The following formats are available: HTML,
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