Tárraga López P J, Celada Rodríguez A, Cerdán Oliver M, Solera Albero J, Ocaña López J M, de Miguel Clavé J
Centro de Salud de AP Casas Ibáñez, Albacete.
Aten Primaria. 2001 Jan;27(1):18-24. doi: 10.1016/s0212-6567(01)78767-7.
To perform an economics evaluation of lipid-lowering therapy with atorvastatin and simvastatin in patients with hypercholesterolemia in primary care setting.
Cost-effectiveness analysis (CEA) has been carried out by means of an open, random, prospective, "real world" study, with hypercholesterolemic patients (total cholesterol [TC] > 240 mg/dl and cLDL > 160 mg/dl).
A total of 92 patients were included (44.8% males), with a mean age of 64.9 +/- 9.4 years old (mean +/- standard deviation). 41.4% were diabetics, 62.1% hypertensives and 16.1% smokers.
Patients were allocated to simvastatin 20 mg/day (44) and atorvastatin. 10 mg/day (48) for 6 months. ASSESSMENT AND MAIN RESULTS: Both therapies reduced significantly cLDL, TC and triglycerides at the end of the study. Atorvastatin reduced lipids faster than simvastatin at 3 months (p < 0.05), but significant differences could not be observed at 6 months. Atorvastatin reduced cLDL levels by 21.5 +/- 13.2% and 23.8 +/- 13.9% at 3 and 6 months, respectively, versus 16.4 +/- 14.2% and 22.8 +/- 10.8% with simvastatin. By these reductions, 54.2% of patients treated with atorvastatin and 50.0% of those allocated to simvastatin reached therapeutic goals of cLDL control. Atorvastatin 10 mg was more cost-effective than simvastatin 20 mg; 95,406 versus 101,335 pts per patient reaching therapeutic goals, respectively, which means that simvastatin need an extra cost of 24,833 pts per patient reaching therapeutic goals to be as efficient as atorvastatin. Sensitivity analysis to control for uncertainty confirmed the results of cost-effectiveness analysis.
Both statins were effective as lipid-lowering agents. However, atorvastatin 10 mg was more efficient than simvastatin 20 mg due to a better cost-effectiveness ratio.
在基层医疗环境中，对阿托伐他汀和辛伐他汀用于高胆固醇血症患者的降脂治疗进行经济学评价。
通过一项开放、随机、前瞻性的“真实世界”研究进行成本效益分析（CEA），研究对象为高胆固醇血症患者（总胆固醇[TC]>240mg/dl且低密度脂蛋白胆固醇[cLDL]>160mg/dl）。
共纳入92例患者（男性占44.8%），平均年龄64.9±9.4岁（均值±标准差）。41.4%为糖尿病患者，62.1%为高血压患者，16.1%为吸烟者。
患者被分配至辛伐他汀20mg/天组（44例）和阿托伐他汀10mg/天组（48例），治疗6个月。
在研究结束时，两种治疗方法均显著降低了cLDL、TC和甘油三酯水平。阿托伐他汀在3个月时降低血脂的速度比辛伐他汀快（p<0.05），但在6个月时未观察到显著差异。阿托伐他汀在3个月和6个月时分别使cLDL水平降低21.5±13.2%和23.8±13.9%，而辛伐他汀分别为16.4±14.2%和22.8±10.8%。通过这些降低幅度，接受阿托伐他汀治疗的患者中有54.2%以及分配至辛伐他汀组的患者中有50.0%达到了cLDL控制的治疗目标。阿托伐他汀10mg比辛伐他汀20mg更具成本效益；达到治疗目标的每位患者分别为95406和101335 pts，这意味着辛伐他汀要达到与阿托伐他汀相同的疗效，每位达到治疗目标的患者需要额外花费24833 pts。控制不确定性的敏感性分析证实了成本效益分析的结果。
两种他汀类药物均为有效的降脂药物。然而，由于成本效益比更好，阿托伐他汀10mg比辛伐他汀20mg更有效。
