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KMID : 1170320030090020097
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Korean Journal of Health Economics and Policy
2003 Volume.9 No. 2 p.97 ~ p.123
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Cost-effectiveness of pharmacologic management in hypercholesterolemia
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Ko Su-Kyoung
Yang Bong-Min
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Abstract
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We performed a cost-effectiveness analysis of pharmacologic treatment of high blood cholesterol levels. Agents modeled were mostly used HMG-CoA reductase inhibitors (statins); simvastatin, atorvastatin and rosuvastatin. Total costs for one year of treatment with each statin were estimated from the perspective of the healthcare system. The cost components considered in the model were medical consultations, drug acquisition cost, blood cholesterol tests and liver function test,
cost of treating any side-effect and cost of monitoring the effect of therapy. Cost was estimated based on hypothetical cohort of patients treated by NCEP ATP III guideline. A meta-analysis of statin clinical trial was conducted to determine pharmacologic effect. Effects were defined as the percent change of blood cholesterol (TC, LDL-C, HDL-C, LDL-C/HDL-C) level. And Cost-effectiveness was calculated as annual acqusition cost / percentage blood cholesterol change.
In general, rosuvastatin was more effective and more cost-effective at reducing cholesterol levels than atorvastatin and simvastatin. Atorvastatin was more effective but less cost effective than simvastatin. Rosuvastatin 10mg/day was the most cost effective at 19,485won/year/percentage TC reduction. For LDL-C, HDL-C and LDL-C/HDL-C, rosuvastatin 10mg/day was also the most efficient. Sensitivity analysis show that the model is robust to changes in assumptions about the cost of therapy, the effect of therapy and drug price.
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KEYWORD
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Cost-effectiveness, Pharmacologic management, Hypercholesterolemia
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