Document Detail

Cost-effectiveness of simvastatin in the secondary prevention of coronary artery disease in Canada.
MedLine Citation:
PMID:  9099167     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine the cost-effectiveness of simvastatin in the secondary prevention of coronary artery disease (CAD) in Canada. DESIGN: Cost-effectiveness model based on results from the Scandinavian Simvastatin Survival Study (45 study) and cost and resource utilization data from Canadian sources to simulate the economic impact of long-term simvastatin treatment (15 years). PATIENTS: Subjects with mean age of 59.4 years at recruitment into 4S study. OUTCOME MEASURES: Overall death rate and incidence of 5 major nonfatal events associated with CAD: myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, stroke and transient ischemic attack. Direct medical costs associated with CAD were assessed from the perspective of provincial ministries of health (i.e., costs borne by the ministries); the impact of simvastatin treatment on these costs was determined. RESULTS: The 4S study, with a median follow-up of 5.4 years, showed significantly reduced mortality and morbidity among the patients given simvastatin compared with the control subjects. Three premises were designed to predict the consequences of simvastatin treatment of CAD in Canada over 15 years, 10 years beyond the end of the 4S study. The 2 most probable premises, which assumed that the clinical benefits of simvastatin would be cumulative for either the first 10 years or the full 15 years of the model, had incremental costs per year of life gained (cost-effectiveness ratio) of $9867 and $6108 respectively. CONCLUSION: This model suggests that simvastatin provides a cost-effective approach to the long-term prevention of secondary CAD in Canada.
M Rivière; S Wang; C Leclerc; C Fitzsimon; R Tretiak
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne     Volume:  156     ISSN:  0820-3946     ISO Abbreviation:  CMAJ     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-05-08     Completed Date:  1997-05-08     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  9711805     Medline TA:  CMAJ     Country:  CANADA    
Other Details:
Languages:  eng     Pagination:  991-7     Citation Subset:  AIM; IM    
Department of Health Economics, Quintiles Canada Inc., Montreal, QC.
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MeSH Terms
Antilipemic Agents / administration & dosage,  economics*
Canada / epidemiology
Coronary Disease / drug therapy,  economics*,  mortality
Cost-Benefit Analysis
Enzyme Inhibitors / administration & dosage,  economics*
Health Resources / economics,  statistics & numerical data,  utilization*
Health Services Research
Lovastatin / administration & dosage,  analogs & derivatives*,  economics
Middle Aged
Models, Economic
Survival Analysis
Time Factors
Reg. No./Substance:
0/Antilipemic Agents; 0/Enzyme Inhibitors; 75330-75-5/Lovastatin; 79902-63-9/Simvastatin
Comment In:
CMAJ. 1997 Apr 1;156(7):1005-7   [PMID:  9099170 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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