Cost-effectiveness ratio of cholesterol level control
The cost-effectiveness of non-pharmacological interventions to reduce LDL cholesterol is unclear. Pharmacological interventions are clearly cost-effective in certain conditions, and the available data allow selecting recommendations taking into account the initial risk of CHD. Early analyzes of cholesterol reduction for the purpose of secondary prophylaxis, in which data from cholesteramine studies were used, showed a very high cost of interventions, largely due to the fact that the available drugs were ineffective. On the contrary, a recent analysis of the results of statin therapy after the addition of two more generic drugs in 2006 showed that they are cost-effective for a larger number of individuals.
Before the advent of generics Prosser L.A. et al. used data from several large, long-term, randomized, controlled studies of statin Coronary Heart Disease Policy. When using statins in primary prevention, it was not possible to achieve a cost-effectiveness ratio of $ 50,000 for QALY in none of the subgroups ($ 1.4 million for QALY). In secondary prevention, the cost-effectiveness ratio was in the range of $ 1,800 for QALY for men 45-54 years old and $ 40 thousand for women 35-44 years old. Statin therapy has also been cost effective for patients 75-84 years of age.
All QALY scores are very sensitive to the cost of drugs, and it can be expected to noticeably decrease as the generics appear. Simvastatin and pravastatin became available as generics in 2006, in addition to lovastatin, which has been prescribed in the form of a generic since 1999. A recent analysis showed that a generic simvastatin at a dose of 40 mg / day can reduce the cost of a saved life by $ 1,350 per year among people at risk vascular events> 1% regardless of age at the start of treatment.