Key result
Rosuvastatin 10 mg daily significantly reduced major cardiovascular events compared to placebo (1.04 vs. 1.20 per patient; P<0.001), with an estimated cost of £1840 per major event avoided.
Why the study?
Is rosuvastatin 10 mg daily cost-effective compared to placebo in older patients with systolic heart failure?
RCT
Yes
Is rosuvastatin 10 mg daily cost-effective compared to placebo in older patients with systolic heart failure?
Mean Difference: 0.164 (95% CI 0.075–0.254)
Absolute Event Rate: 1.04% vs 1.2%
p-value: p=< 0.001
In older patients with systolic heart failure, the reduction in major CV events with rosuvastatin partially offsets the cost of the drug by 44% through reduced hospitalization and procedure costs.
May partially offset costs via fewer events in systolic HF; leaves open need for RCT confirmation before practice change.
AIMS: To estimate the cost-effectiveness of 10 mg rosuvastatin daily for older patients with systolic heart failure in the Controlled Rosuvastatin Multinational Study in Heart Failure (CORONA) trial. METHODS AND RESULTS: This within trial analysis of CORONA used major cardiovascular (CV) events as the outcome measure. Resource use was valued and the costs of hospitalizations, procedures, and statin use compared. Cost-effectiveness was estimated as cost per major CV event avoided. There were significantly fewer major CV events in the rosuvastatin group compared with the placebo group (1.04 vs. 1.20 per patient; difference 0.164; 95% CI: 0.075-0.254, P < 0.001). The average cost of CV hospitalizations and procedures was significantly lower for those receiving rosuvastatin ( pound1531 vs. pound1769; difference pound238; 95% CI: pound73-403, P = 0.005); the additional cost of the statin resulted in significantly higher total costs for the rosuvastatin group ( pound1769 vs. pound2072; difference pound303; 95% CI: pound138-468, P < 0.001). Overall, rosuvastatin was found to cost pound1840 (95% CI: pound562-6028) per major CV event avoided. CONCLUSION: This economic analysis showed that a significant reduction in major CV events with rosuvastatin led to significantly reduced costs of CV hospitalizations and procedures. The reduction in associated costs for major CV events was found to offset partially (by 44%) the cost of rosuvastatin treatment in patients with systolic heart failure.
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Lorgelly et al. (2009) conducted an RCT in systolic heart failure. Rosuvastatin vs. Placebo was evaluated on major cardiovascular (CV) events (difference 0.164, 95% CI 0.075-0.254, p=< 0.001). Rosuvastatin 10 mg daily significantly reduced major cardiovascular events compared to placebo (1.04 vs. 1.20 per patient; P<0.001), with an estimated cost of £1840 per major event avoided.
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