Document Detail

Statins: cost analysis in Indian scenario from eight major clinical trials.
MedLine Citation:
PMID:  20739765     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND AIMS: Coronary heart disease (CHD) is the leading cause of death in India resulting in loss of young Indians. Statins have proved to reduce the CHD mortality in various clinical trials. The aim of the study is to find the cost-effectiveness ratio (CER) for each major coronary event averted and a coronary death avoided by use of statins in different clinical settings based on the data from the major clinical trials on statins.
MATERIALS AND METHODS: Using electronic database and as per our inclusion and exclusion criteria we selected the West of Scotland Coronary Prevention Study (WOSCOPS), the Air Force Coronary Atherosclerosis Prevention Study (AFCAPS) and the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA) study for primary prevention; the Cholesterol and Recurrent Events Trial (CARE), the Long-term Intervention with Pravastatin in Ischemic Disease (LIPID) Study and the Scandinavian Simvastatin Survival Study (4S) for secondary prevention and two studies, the Heart Protection Study (HPS) and the Pravastatin in elderly individuals at risk of vascular disease (PROSPER) study for high-risk patients. The results of these studies were used for cost-effectiveness analysis of statins in different patient groups.
STATISTICAL ANALYSIS: Absolute risk reduction, Number Needed to Benefit (NNTB), NNTB/year for total sample and in subgroups of males, females and age >65 was derived. CER for branded and generic versions was calculated by using the prices of statins listed in Indian Drug Review Triple i.
RESULTS: Cost-effectiveness ratio (CER) in primary prevention studies i.e., the WOSCOPS, the AFCAPS and the ASCOT-LLA was Rs. 25.8 lacs, Rs. 23.8 lacs and Rs. 7.9 lacs per major coronary event averted respectively. CER in secondary prevention studies i.e., the CARE and the LIPID was approximately Rs. 20 lacs per major coronary event averted while it was Rs. 52.4 lacs and Rs. 37 lacs per coronary heart disease (CHD) death avoided. CER from the 4S was Rs. 6.9 lacs per major coronary event and Rs. 16.9 lacs per CHD death averted. CER in the HPS and the PROSPER study was Rs. 17.9 lacs and Rs. 27.1 lacs per major coronary event avoided in high-risk patients.
CONCLUSION: Cost associated with the use of statins is higher in primary prevention as compared to secondary prevention. More studies are needed to confirm the cost-effectiveness of statins to make any decision for health policy.
J Sanmukhani; V Shah
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of postgraduate medicine     Volume:  56     ISSN:  0022-3859     ISO Abbreviation:  J Postgrad Med     Publication Date:    2010 Jul-Sep
Date Detail:
Created Date:  2010-08-26     Completed Date:  2010-11-01     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  2985196R     Medline TA:  J Postgrad Med     Country:  India    
Other Details:
Languages:  eng     Pagination:  196-200     Citation Subset:  IM    
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MeSH Terms
Aged, 80 and over
Asian Continental Ancestry Group
Coronary Disease / economics*,  prevention & control
Cost-Benefit Analysis
Hydroxymethylglutaryl-CoA Reductase Inhibitors / economics*,  therapeutic use
Middle Aged
Randomized Controlled Trials as Topic
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

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