Section of Public Health and Health Policy, Faculty of Medicine, University of Glasgow, Glasgow G12 8RZ, UK.
Eur J Heart Fail. 2010 Jan;12(1):66-74. doi: 10.1093/eurjhf/hfp172.
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.
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.
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.
评估在心力衰竭的控制瑞舒伐他汀多国研究(CORONA)试验中,10mg 瑞舒伐他汀每日治疗老年收缩性心力衰竭患者的成本效益。
本试验内分析采用主要心血管(CV)事件作为结局指标。对资源利用进行了评估,并比较了住院、手术和他汀类药物使用的成本。成本效益以每例主要 CV 事件避免的成本来衡量。与安慰剂组相比,瑞舒伐他汀组的主要 CV 事件明显减少(每例患者分别为 1.04 次和 1.20 次;差异为 0.164;95%CI:0.075-0.254,P<0.001)。接受瑞舒伐他汀治疗的患者 CV 住院和手术的平均成本显著降低(分别为 1531 英镑和 1769 英镑;差异为 238 英镑;95%CI:73-403,P=0.005);他汀类药物的额外成本导致瑞舒伐他汀组的总费用显著增加(分别为 1769 英镑和 2072 英镑;差异为 303 英镑;95%CI:138-468,P<0.001)。总体而言,瑞舒伐他汀每例主要 CV 事件避免的费用为 1840 英镑(95%CI:562-6028 英镑)。
本经济分析显示,瑞舒伐他汀显著减少主要 CV 事件,导致 CV 住院和手术的成本显著降低。主要 CV 事件相关成本的降低部分抵消了(44%)收缩性心力衰竭患者使用瑞舒伐他汀治疗的成本。