Five years of pravastatin treatment in middle-aged men without prior MI saved the NHS £710,000 (P<0.001) and gained 136 QALYs (P=0.017) per 1000 patients over 15 years.
RCT (n=6,595)
randomized
Does 5 years of pravastatin 40 mg/day reduce healthcare resource utilization and improve cost-effectiveness over 15 years in men without a history of myocardial infarction?
Five years of primary prevention with pravastatin in middle-aged men is cost-saving and increases quality-adjusted life years over a 15-year period.
Effect estimate: £710,000 saved per 1000 patients
p-value: p=<0.001
AIMS: To assess the impact on healthcare resource utilization, costs, and quality of life over 15 years from 5 years of statin use in men without a history of myocardial infarction in the West of Scotland Coronary Prevention Study (WOSCOPS). METHODS: Six thousand five hundred and ninety-five participants aged 45-54 years were randomized to 5 years treatment with pravastatin (40 mg) or placebo. Linkage to routinely collected health records extended follow-up for secondary healthcare resource utilization to 15 years. The following new results are reported: cause-specific first and recurrent cardiovascular hospital admissions including myocardial infarction, heart failure, stroke, coronary revascularization and angiography; non-cardiovascular hospitalization; days in hospital; quality-adjusted life years (QALYs); costs of pravastatin treatment, treatment safety monitoring, and hospital admissions. RESULTS: Five years treatment of 1000 patients with pravastatin (40 mg/day) saved the NHS £710 000 (P < 0.001), including the cost of pravastatin and lipid and safety monitoring, and gained 136 QALYs (P = 0.017) over the 15-year period. Benefits per 1000 subjects, attributable to prevention of cardiovascular events, included 163 fewer admissions and a saving of 1836 days in hospital, with fewer admissions for myocardial infarction, stroke, heart failure and coronary revascularization. There was no excess in non-cardiovascular admissions or costs (or in admissions associated with diabetes or its complications) and no evidence of heterogeneity of effect over sub-groups defined by baseline cardiovascular risk. CONCLUSION: Five years' primary prevention treatment of middle-aged men with a statin significantly reduces healthcare resource utilization, is cost saving, and increases QALYs. Treatment of even younger, lower risk individuals is likely to be cost-effective.
McConnachie et al. (Tue,) conducted a rct in Primary prevention of cardiovascular disease (n=6,595). pravastatin vs. placebo was evaluated on Healthcare resource utilization, costs, and quality of life over 15 years (£710,000 saved per 1000 patients, p=<0.001). Five years of pravastatin treatment in middle-aged men without prior MI saved the NHS £710,000 (P<0.001) and gained 136 QALYs (P=0.017) per 1000 patients over 15 years.