Abstract
To assess the cost-effectiveness of cholesterol-reducing therapy with cholestyramine and simvastatin in the primary prevention of coronary artery disease in The Netherlands, a model of coronary artery disease incidence was used based on multivariate logistic risk functions from the Framingham study. For men with initial cholesterol levels of 8 mmol/liter, the cost per year of life saved of cholestyramine, expressed in Dutch guilders (NLG; 1 NLG = $0.50), ranges from approximately NLG 208,000 to NLG 483,000, depending on the patient's age at initiation of therapy. For simvastatin, cost-effectiveness ranges from NLG 46,000 to NLG 98,000 per year of life saved among this group of men. Similar differences between simvastatin and cholestyramine therapy prevail among women, although the costs per year of life saved for both agents are considerably higher. These results suggest that (1) simvastatin is substantially more cost effective than is cholestyramine; (2) simvastatin therapy compares favorably with other generally accepted medical practices, especially if treatment is initiated at an early age; and (3) as its long-term safety record becomes more established, simvastatin may become accepted as a drug of first choice in the treat...Continue Reading
References
Nov 11, 1988·The American Journal of Cardiology·J A Tobert
Nov 12, 1987·The New England Journal of Medicine·M H FrickV Manninen
Jan 20, 1984·JAMA : the Journal of the American Medical Association
Jan 20, 1984·JAMA : the Journal of the American Medical Association
Citations
May 1, 1996·Social Science & Medicine·E Rieger
Sep 26, 1996·The American Journal of Cardiology·T A Jacobson
Feb 1, 1996·Cardiology Clinics·T A Pearson, H J Swan
Aug 1, 1993·Australian and New Zealand Journal of Medicine·C J LintottJ Bremer
Jul 2, 2008·BMC Family Practice·Stefaan BartholomeeusenFrank Buntinx
Jul 1, 1991·American Journal of Public Health·T W Kelsey, P L Jenkins
May 13, 1999·Clinical Therapeutics·D E HillemanC A Pedersen
Aug 30, 2003·Acta Clinica Belgica·D Devroey, W Betz
Dec 15, 1991·The American Journal of Cardiology·J A Mauskopf, T L Wenger
Apr 5, 2012·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Bob J H van KempenM G Myriam Hunink
Apr 20, 2005·PharmacoEconomics·Pedro J Tárraga-LópezJaime De Miguel-Clave
May 15, 1996·Circulation·T R PedersenJ S Schwartz
Jan 7, 1997·Circulation·A N TostesonL Goldman
Mar 6, 2007·PharmacoEconomics·Pearl D GumbsOlaf H Klungel
Oct 1, 1999·Environmental Health and Preventive Medicine·N NakanishiK Tatara
May 13, 1999·Journal of Epidemiology and Community Health·T van der WeijdenR P Grol
Oct 1, 1991·Medical Informatics = Médecine Et Informatique·M JohannessonB Jönsson
Oct 29, 2017·PharmacoEconomics·Jonas Hermansson, Thomas Kahan
Jul 1, 1995·The Annals of Pharmacotherapy·I HsuN E Johnson
Sep 5, 1994·PharmacoEconomics·A Pelc
Sep 4, 1997·Journal of Health Services Research & Policy·S MorrisD Pettitt
Dec 8, 1996·Journal of Health Services Research & Policy·M SculpherM Buxton
Feb 28, 1998·Medizinische Klinik·K ObermannG C Mautner
Sep 5, 1994·PharmacoEconomics·J M EisenbergB Lovatt