PMID: 16520473Mar 8, 2006Paper

Aspirin, statins, or both drugs for the primary prevention of coronary heart disease events in men: a cost-utility analysis

Annals of Internal Medicine
Michael PignoneMark J Pletcher

Abstract

Aspirin and statins are both effective for primary prevention of coronary heart disease (CHD), but their combined use has not been well studied. To perform a cost-utility analysis of the effects of aspirin therapy, statin therapy, combination therapy with both drugs, and no pharmacotherapy for the primary prevention of CHD events in men. Markov model. Published literature. Middle-aged men without a history of cardiovascular disease at 6 levels of 10-year risk for CHD (2.5%, 5%, 7.5%, 10%, 15%, and 25%). Lifetime. Third-party payer. Low-dose aspirin, a statin, both drugs as combination therapy, or no therapy. Cost per quality-adjusted life-year gained. For 45-year-old men who do not smoke, are not hypertensive, and have a 10-year risk for CHD of 7.5%, aspirin was more effective and less costly than no treatment. The addition of a statin to aspirin therapy produced an incremental cost-utility ratio of 56,200 dollars per quality-adjusted life-year gained compared with aspirin alone. Excess risk for hemorrhagic stroke and gastrointestinal bleeding with aspirin, risk for CHD, the cost of statins, and the disutility of taking medication had important effects on the cost-utility ratios. Several input parameters, particularly adverse e...Continue Reading

Citations

Jan 1, 2013·The European Journal of Health Economics : HEPAC : Health Economics in Prevention and Care·Björn StollenwerkUwe Siebert
Sep 9, 2010·Journal of General Internal Medicine·William J GordonMichael A Steinman
May 18, 2013·Journal of General Internal Medicine·Michael PignoneMark J Pletcher
May 17, 2013·Drugs·Rubén Casado-ArroyoAngel Lanas
Jun 7, 2012·The Journal of Ambulatory Care Management·Andrew R H Dalton, Michael Soljak
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Dec 6, 2008·Digestive Diseases and Sciences·Chin HurG Scott Gazelle
Sep 3, 2010·The American Journal of Clinical Nutrition·Adam M BernsteinWalter C Willett
Sep 22, 2010·Nature Reviews. Endocrinology·Michael Pignone, Craig D Williams
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