Cost-effectiveness of cholesterol-lowering therapy with pravastatin in patients with previous acute coronary syndromes aged 65 to 74 years compared with younger patients: Results from the LIPID study

AM Tonkin, S Eckermann, H White, D Friedlander, P Glasziou, P Magnus, A Kirby, S Mulray, M Denton, M Sallaberger, D Hunt, J Simes, LIPID Study Grp

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Abstract

Background We compared cost-effectiveness of pravastatin in a placebo-controlled trial in 5500 younger (31-64 years) and 3514 older patients (65-74 years) with previous acute coronary syndromes.

Methods Hospitalizations and long-term medication within the 6 years of the trial were estimated in all patients. Drug dosage, nursing home, and ambulatory care costs were estimated from substudies. Incremental costs per life saved of pravastatin relative to placebo were estimated from treatment effects and resource use.

Results Over 6 years, pravastatin reduced all-cause mortality by 4.3% in the older patients and by 2.3% in the younger patients. Older patients assigned pravastatin had marginally lower cost of pravastatin and other medication over 6 years (A$4442 vs A$4637), but greater cost offsets (A$2061 vs. A$897) from lower rates of hospitalizations. The incremental cost per life saved with pravastatin was A$55500 in the old and A$167200 in the young. Assuming no treatment effect beyond the study period, the life expectancy to age 82 years of additional survivors was 9.1 years in the older and. 17.3 years in the younger. Estimated additional life-years saved from pravastatin therapy were 0.39 years for older and 0.40 years for younger patients. Incremental costs per life-year saved were A$7581 in the older and A$1.4944 in the younger, if discounted at 5% per annum.

Conclusions Pravastatin therapy was more cost-effective among older than younger patients, because of their higher baseline risk and greater cost offsets, despite their shorter life expectancy.

Original languageEnglish
Pages (from-to)1305-1312
Number of pages8
JournalAmerican Heart Journal
Volume151
Issue number6
DOIs
Publication statusPublished - Jun 2006
Externally publishedYes

Cite this

Tonkin, AM ; Eckermann, S ; White, H ; Friedlander, D ; Glasziou, P ; Magnus, P ; Kirby, A ; Mulray, S ; Denton, M ; Sallaberger, M ; Hunt, D ; Simes, J ; LIPID Study Grp. / Cost-effectiveness of cholesterol-lowering therapy with pravastatin in patients with previous acute coronary syndromes aged 65 to 74 years compared with younger patients : Results from the LIPID study. In: American Heart Journal. 2006 ; Vol. 151, No. 6. pp. 1305-1312.
@article{ead8e9e4e14a4c25879b06167d2e8300,
title = "Cost-effectiveness of cholesterol-lowering therapy with pravastatin in patients with previous acute coronary syndromes aged 65 to 74 years compared with younger patients: Results from the LIPID study",
abstract = "Background We compared cost-effectiveness of pravastatin in a placebo-controlled trial in 5500 younger (31-64 years) and 3514 older patients (65-74 years) with previous acute coronary syndromes.Methods Hospitalizations and long-term medication within the 6 years of the trial were estimated in all patients. Drug dosage, nursing home, and ambulatory care costs were estimated from substudies. Incremental costs per life saved of pravastatin relative to placebo were estimated from treatment effects and resource use.Results Over 6 years, pravastatin reduced all-cause mortality by 4.3{\%} in the older patients and by 2.3{\%} in the younger patients. Older patients assigned pravastatin had marginally lower cost of pravastatin and other medication over 6 years (A$4442 vs A$4637), but greater cost offsets (A$2061 vs. A$897) from lower rates of hospitalizations. The incremental cost per life saved with pravastatin was A$55500 in the old and A$167200 in the young. Assuming no treatment effect beyond the study period, the life expectancy to age 82 years of additional survivors was 9.1 years in the older and. 17.3 years in the younger. Estimated additional life-years saved from pravastatin therapy were 0.39 years for older and 0.40 years for younger patients. Incremental costs per life-year saved were A$7581 in the older and A$1.4944 in the younger, if discounted at 5{\%} per annum.Conclusions Pravastatin therapy was more cost-effective among older than younger patients, because of their higher baseline risk and greater cost offsets, despite their shorter life expectancy.",
author = "AM Tonkin and S Eckermann and H White and D Friedlander and P Glasziou and P Magnus and A Kirby and S Mulray and M Denton and M Sallaberger and D Hunt and J Simes and {LIPID Study Grp}",
year = "2006",
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doi = "10.1016/j.ahj.2005.07.014",
language = "English",
volume = "151",
pages = "1305--1312",
journal = "American Heart Journal",
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Tonkin, AM, Eckermann, S, White, H, Friedlander, D, Glasziou, P, Magnus, P, Kirby, A, Mulray, S, Denton, M, Sallaberger, M, Hunt, D, Simes, J & LIPID Study Grp 2006, 'Cost-effectiveness of cholesterol-lowering therapy with pravastatin in patients with previous acute coronary syndromes aged 65 to 74 years compared with younger patients: Results from the LIPID study' American Heart Journal, vol. 151, no. 6, pp. 1305-1312. https://doi.org/10.1016/j.ahj.2005.07.014

Cost-effectiveness of cholesterol-lowering therapy with pravastatin in patients with previous acute coronary syndromes aged 65 to 74 years compared with younger patients : Results from the LIPID study. / Tonkin, AM; Eckermann, S; White, H; Friedlander, D; Glasziou, P; Magnus, P; Kirby, A; Mulray, S; Denton, M; Sallaberger, M; Hunt, D; Simes, J; LIPID Study Grp.

In: American Heart Journal, Vol. 151, No. 6, 06.2006, p. 1305-1312.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Cost-effectiveness of cholesterol-lowering therapy with pravastatin in patients with previous acute coronary syndromes aged 65 to 74 years compared with younger patients

T2 - Results from the LIPID study

AU - Tonkin, AM

AU - Eckermann, S

AU - White, H

AU - Friedlander, D

AU - Glasziou, P

AU - Magnus, P

AU - Kirby, A

AU - Mulray, S

AU - Denton, M

AU - Sallaberger, M

AU - Hunt, D

AU - Simes, J

AU - LIPID Study Grp

PY - 2006/6

Y1 - 2006/6

N2 - Background We compared cost-effectiveness of pravastatin in a placebo-controlled trial in 5500 younger (31-64 years) and 3514 older patients (65-74 years) with previous acute coronary syndromes.Methods Hospitalizations and long-term medication within the 6 years of the trial were estimated in all patients. Drug dosage, nursing home, and ambulatory care costs were estimated from substudies. Incremental costs per life saved of pravastatin relative to placebo were estimated from treatment effects and resource use.Results Over 6 years, pravastatin reduced all-cause mortality by 4.3% in the older patients and by 2.3% in the younger patients. Older patients assigned pravastatin had marginally lower cost of pravastatin and other medication over 6 years (A$4442 vs A$4637), but greater cost offsets (A$2061 vs. A$897) from lower rates of hospitalizations. The incremental cost per life saved with pravastatin was A$55500 in the old and A$167200 in the young. Assuming no treatment effect beyond the study period, the life expectancy to age 82 years of additional survivors was 9.1 years in the older and. 17.3 years in the younger. Estimated additional life-years saved from pravastatin therapy were 0.39 years for older and 0.40 years for younger patients. Incremental costs per life-year saved were A$7581 in the older and A$1.4944 in the younger, if discounted at 5% per annum.Conclusions Pravastatin therapy was more cost-effective among older than younger patients, because of their higher baseline risk and greater cost offsets, despite their shorter life expectancy.

AB - Background We compared cost-effectiveness of pravastatin in a placebo-controlled trial in 5500 younger (31-64 years) and 3514 older patients (65-74 years) with previous acute coronary syndromes.Methods Hospitalizations and long-term medication within the 6 years of the trial were estimated in all patients. Drug dosage, nursing home, and ambulatory care costs were estimated from substudies. Incremental costs per life saved of pravastatin relative to placebo were estimated from treatment effects and resource use.Results Over 6 years, pravastatin reduced all-cause mortality by 4.3% in the older patients and by 2.3% in the younger patients. Older patients assigned pravastatin had marginally lower cost of pravastatin and other medication over 6 years (A$4442 vs A$4637), but greater cost offsets (A$2061 vs. A$897) from lower rates of hospitalizations. The incremental cost per life saved with pravastatin was A$55500 in the old and A$167200 in the young. Assuming no treatment effect beyond the study period, the life expectancy to age 82 years of additional survivors was 9.1 years in the older and. 17.3 years in the younger. Estimated additional life-years saved from pravastatin therapy were 0.39 years for older and 0.40 years for younger patients. Incremental costs per life-year saved were A$7581 in the older and A$1.4944 in the younger, if discounted at 5% per annum.Conclusions Pravastatin therapy was more cost-effective among older than younger patients, because of their higher baseline risk and greater cost offsets, despite their shorter life expectancy.

U2 - 10.1016/j.ahj.2005.07.014

DO - 10.1016/j.ahj.2005.07.014

M3 - Article

VL - 151

SP - 1305

EP - 1312

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 6

ER -