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KMID : 0387319990090030070
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Korean Journal of Health Policy and Administration
1999 Volume.9 No. 3 p.70 ~ p.94
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Cost-effectiveness Analysis of Pharmacologic Treatment in Hypercholesterolemia
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Jung Kyoung-Rae
Moon Ok-Ryun
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Abstract
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This paper was performed for a cost-effectiveness analysis of pharmacologic treatment of hypercholesterolemia. Agents modeled were cholestyramine, gemfibrozil, bezafibrate. lovastatin, pravastatin, simvastatin. Pharmacologic effectiveness was estimated by regression from reported clinical trials. Pharmacologic effects were expressed as the percent change of blood cholesterol level. Cost estimates included patients travel expenses and time loss as well as resource consumption in the health care sector.
Bezafibrate was the most efficient agent for reducing total cholesterol levels, having an cost over 1 year of W31,400 per percent reduction in total cholesterol. Simvastatin (10mg/d) was also efficient(W33,100 per percent reduction). Cholestyramine(8g/d) was least efficient at W90,200. For low-density lipoprotein cholesterol, simvastatin(10mg/d) was most efficient, at W23,200 per percent reduction, followed by lovastatin(20mg/d) at W28,000. Gemfibrozil was least efficient at W77,800 per percent reduction. For high-density lipoprotein cholesterol, bezafibrate(400mg/d) was most efficient at W39,300 per percent increase of high-density lipoprotein cholesterol. Cholestyramine was least efficient at W514,700. Analyses combining low-density lipoprotein cholesterol and high-density cholesterol effects suggest that bezafibrate(600mg/d) and simvastatin (10mg/d) were most efficient for reducing cardiovascular risk.
The cost-effectiveness analysis results show that both simvastatin and bezafibrate could be efficient treatment. Simvastatin provide more effective treatment at higher cost, whereas bezafibrate is more cost-effective, as it may be less effective, at lower cost. Therefore, clinicians should choose reasonable treatment according to the patient´s needs.
This pharmacoeconimc analysis will provide a guideline for efficient pharmacologic treatment and also be reference data for pricing new drugs.
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KEYWORD
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cost-effectiveness analysis, pharmacologic treatment, hypercholesterolemia, bezafibrate, simvastatin
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