Document Detail


A pharmacoeconomic evaluation of the Myocardial Ischaemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study in the United Kingdom.
MedLine Citation:
PMID:  12648032     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the short-term healthcare costs associated with intensive lipid lowering with atorvastatin initiated within 24-96 hours of the occurrence of acute coronary syndrome (ACS) in patients in the UK. METHODS: Patient-level clinical outcome data from the Myocardial Ischaemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial and standard cost data were used to compare the total expected 16-week cost per patient on atorvastatin 80 mg/day versus placebo. Clinical outcomes assessed included the following: death; cardiac arrest with resuscitation; nonfatal myocardial infarction; worsening angina pectoris with objective evidence of myocardial ischaemia requiring rehospitalisation; surgical or percutaneous coronary revascularisation; nonfatal stroke; hospitalisation for angina without objective evidence of myocardial ischaemia; and new or worsening congestive heart failure requiring rehospitalisation. All relevant direct medical costs from the perspective of the NHS were considered. RESULTS: The total expected cost was pound 784.05 per patient in the placebo cohort and pound 851.59 per patient in the atorvastatin cohort, resulting in an incremental cost of pound 67.54 per patient in the atorvastatin group. The cost per event avoided was pound 1762.04. A third of the cost of atorvastatin treatment was offset within 16 weeks by the cost savings resulting from the reduction in the number of events in the atorvastatin cohort compared with the placebo cohort. CONCLUSION: The clinical benefits of short-term intensive atorvastatin treatment administered after ACS is attainable through a marginal increase in 'upfront' costs.
Authors:
Nigel Buller; David Gillen; Roman Casciano; John Doyle; Koo Wilson
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  PharmacoEconomics     Volume:  21 Suppl 1     ISSN:  1170-7690     ISO Abbreviation:  Pharmacoeconomics     Publication Date:  2003  
Date Detail:
Created Date:  2003-03-21     Completed Date:  2003-06-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9212404     Medline TA:  Pharmacoeconomics     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  25-32     Citation Subset:  T    
Affiliation:
Department of Cardiology, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
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MeSH Terms
Descriptor/Qualifier:
Anticholesteremic Agents / economics*,  therapeutic use*
Cholesterol / blood
Cohort Studies
Cost-Benefit Analysis
Double-Blind Method
Endpoint Determination
Great Britain
Health Care Costs
Heptanoic Acids / economics*,  therapeutic use*
Hospitalization
Humans
Hypercholesterolemia / blood,  complications,  drug therapy*
Myocardial Ischemia / drug therapy*,  etiology,  prevention & control*
Pyrroles / economics*,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Heptanoic Acids; 0/Pyrroles; 110862-48-1/atorvastatin; 57-88-5/Cholesterol

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


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