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Cost-effectiveness of rosuvastatin in comparison with generic atorvastatin and simvastatin in a Swedish population at high risk of cardiovascular events.

Gandhi SK, Jensen MM, Fox KM, Smolen L, Olsson AG, Paulsson T - Clinicoecon Outcomes Res (2012)

Bottom Line: To assess the long-term cost-effectiveness of rosuvastatin therapy compared with generic simvastatin and generic atorvastatin in reducing the incidence of cardiovascular events and mortality in a Swedish population with Framingham risk ≥20%.Probabilistic sensitivity analyses indicated that at a willingness-to-pay threshold of SEK500,000/QALY, rosuvastatin 20 mg would be cost-effective for approximately 75%-85% of simulations relative to atorvastatin or simvastatin 40 mg.Rosuvastatin 20 mg is cost-effective over a lifetime horizon compared with generic simvastatin or atorvastatin 40 mg in patients at high cardiovascular risk in Sweden.

View Article: PubMed Central - PubMed

Affiliation: AstraZeneca LP, Wilmington, DE, USA.

ABSTRACT

Background: To assess the long-term cost-effectiveness of rosuvastatin therapy compared with generic simvastatin and generic atorvastatin in reducing the incidence of cardiovascular events and mortality in a Swedish population with Framingham risk ≥20%.

Methods: A PROBABILISTIC MONTE CARLO SIMULATION MODEL BASED ON DATA FROM JUPITER (THE JUSTIFICATION FOR THE USE OF STATINS IN PREVENTION: an Intervention Trial Evaluating Rosuvastatin) was used to estimate the long-term cost-effectiveness of rosuvastatin 20 mg daily versus simvastatin or atorvastatin 40 mg for the prevention of cardiovascular death and morbidity. The three- stage model included cardiovascular event prevention simulating the 4 years of JUPITER, initial prevention beyond the trial, and subsequent cardiovascular event prevention. A Swedish health care payer perspective (direct costs only) was modeled for a lifetime horizon, with 2008/2009 as the costing period. Univariate and probabilistic sensitivity analyses were performed.

Results: The incremental cost per quality-adjusted life-year (QALY) gained with rosuvastatin 20 mg over simvastatin or atorvastatin 40 mg ranged from SEK88,113 (rosuvastatin 20 mg versus simvastatin 40 mg; Framingham risk ≥30%; net avoidance of 34 events/1000 patients) to SEK497,542 (versus atorvastatin 40 mg: Framingham risk ≥20%; net avoidance of 11 events/1000 patients) over a lifetime horizon. Probabilistic sensitivity analyses indicated that at a willingness-to-pay threshold of SEK500,000/QALY, rosuvastatin 20 mg would be cost-effective for approximately 75%-85% of simulations relative to atorvastatin or simvastatin 40 mg. Sensitivity analyses indicated the findings to be robust.

Conclusion: Rosuvastatin 20 mg is cost-effective over a lifetime horizon compared with generic simvastatin or atorvastatin 40 mg in patients at high cardiovascular risk in Sweden.

No MeSH data available.


(A) Willingness to pay-cost/QALY ICER with a lifetime horizon for Framingham 20% risk population (JUPITER population) rosuvastatin 20 mg versus atorvastatin 40 mg, assuming a generic 95% price reduction from brand. (B) Willingness to pay-cost/QALY ICER with a lifetime horizon for Framingham 20% risk population (JUPITER population) rosuvastatin 20 mg versus simvastatin 40 mg, generic 95% price reduction from brand.Abbreviations: QALY, quality adjusted life year; ICER, incremental cost-effectiveness ratio; SEK, Swedish kronor; JUPITER, the Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin.
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f4-ceor-4-001: (A) Willingness to pay-cost/QALY ICER with a lifetime horizon for Framingham 20% risk population (JUPITER population) rosuvastatin 20 mg versus atorvastatin 40 mg, assuming a generic 95% price reduction from brand. (B) Willingness to pay-cost/QALY ICER with a lifetime horizon for Framingham 20% risk population (JUPITER population) rosuvastatin 20 mg versus simvastatin 40 mg, generic 95% price reduction from brand.Abbreviations: QALY, quality adjusted life year; ICER, incremental cost-effectiveness ratio; SEK, Swedish kronor; JUPITER, the Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin.

Mentions: Probabilistic sensitivity analysis was performed to assess the decision uncertainties in multiple model parameters. The cost-effectiveness acceptability curves generated (Figure 4) for different levels of willingness to pay for rosuvastatin 20 mg relative to atorvastatin or simvastatin 40 mg in patients with a Framingham risk ≥20% indicate that, at a maximum willingness to pay threshold of SEK500,000 per QALY gained, rosuvastatin therapy is cost-effective in 74.4% and 85.3% of the model replications, respectively. At a Framingham risk ≥30%, rosuvastatin is cost-effective for 86.9% and 90.3% of model replications when compared with atorvastatin and simvastatin, respectively, at this willingness to pay threshold. At ≥20% risk, rosuvastatin is estimated to be cost-saving versus atorvastatin and simvastatin, respectively, in 24.0% and 8.6% of model replications, and in 29.0% and 14.8% of replications at the ≥30% level.


Cost-effectiveness of rosuvastatin in comparison with generic atorvastatin and simvastatin in a Swedish population at high risk of cardiovascular events.

Gandhi SK, Jensen MM, Fox KM, Smolen L, Olsson AG, Paulsson T - Clinicoecon Outcomes Res (2012)

(A) Willingness to pay-cost/QALY ICER with a lifetime horizon for Framingham 20% risk population (JUPITER population) rosuvastatin 20 mg versus atorvastatin 40 mg, assuming a generic 95% price reduction from brand. (B) Willingness to pay-cost/QALY ICER with a lifetime horizon for Framingham 20% risk population (JUPITER population) rosuvastatin 20 mg versus simvastatin 40 mg, generic 95% price reduction from brand.Abbreviations: QALY, quality adjusted life year; ICER, incremental cost-effectiveness ratio; SEK, Swedish kronor; JUPITER, the Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3278203&req=5

f4-ceor-4-001: (A) Willingness to pay-cost/QALY ICER with a lifetime horizon for Framingham 20% risk population (JUPITER population) rosuvastatin 20 mg versus atorvastatin 40 mg, assuming a generic 95% price reduction from brand. (B) Willingness to pay-cost/QALY ICER with a lifetime horizon for Framingham 20% risk population (JUPITER population) rosuvastatin 20 mg versus simvastatin 40 mg, generic 95% price reduction from brand.Abbreviations: QALY, quality adjusted life year; ICER, incremental cost-effectiveness ratio; SEK, Swedish kronor; JUPITER, the Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin.
Mentions: Probabilistic sensitivity analysis was performed to assess the decision uncertainties in multiple model parameters. The cost-effectiveness acceptability curves generated (Figure 4) for different levels of willingness to pay for rosuvastatin 20 mg relative to atorvastatin or simvastatin 40 mg in patients with a Framingham risk ≥20% indicate that, at a maximum willingness to pay threshold of SEK500,000 per QALY gained, rosuvastatin therapy is cost-effective in 74.4% and 85.3% of the model replications, respectively. At a Framingham risk ≥30%, rosuvastatin is cost-effective for 86.9% and 90.3% of model replications when compared with atorvastatin and simvastatin, respectively, at this willingness to pay threshold. At ≥20% risk, rosuvastatin is estimated to be cost-saving versus atorvastatin and simvastatin, respectively, in 24.0% and 8.6% of model replications, and in 29.0% and 14.8% of replications at the ≥30% level.

Bottom Line: To assess the long-term cost-effectiveness of rosuvastatin therapy compared with generic simvastatin and generic atorvastatin in reducing the incidence of cardiovascular events and mortality in a Swedish population with Framingham risk ≥20%.Probabilistic sensitivity analyses indicated that at a willingness-to-pay threshold of SEK500,000/QALY, rosuvastatin 20 mg would be cost-effective for approximately 75%-85% of simulations relative to atorvastatin or simvastatin 40 mg.Rosuvastatin 20 mg is cost-effective over a lifetime horizon compared with generic simvastatin or atorvastatin 40 mg in patients at high cardiovascular risk in Sweden.

View Article: PubMed Central - PubMed

Affiliation: AstraZeneca LP, Wilmington, DE, USA.

ABSTRACT

Background: To assess the long-term cost-effectiveness of rosuvastatin therapy compared with generic simvastatin and generic atorvastatin in reducing the incidence of cardiovascular events and mortality in a Swedish population with Framingham risk ≥20%.

Methods: A PROBABILISTIC MONTE CARLO SIMULATION MODEL BASED ON DATA FROM JUPITER (THE JUSTIFICATION FOR THE USE OF STATINS IN PREVENTION: an Intervention Trial Evaluating Rosuvastatin) was used to estimate the long-term cost-effectiveness of rosuvastatin 20 mg daily versus simvastatin or atorvastatin 40 mg for the prevention of cardiovascular death and morbidity. The three- stage model included cardiovascular event prevention simulating the 4 years of JUPITER, initial prevention beyond the trial, and subsequent cardiovascular event prevention. A Swedish health care payer perspective (direct costs only) was modeled for a lifetime horizon, with 2008/2009 as the costing period. Univariate and probabilistic sensitivity analyses were performed.

Results: The incremental cost per quality-adjusted life-year (QALY) gained with rosuvastatin 20 mg over simvastatin or atorvastatin 40 mg ranged from SEK88,113 (rosuvastatin 20 mg versus simvastatin 40 mg; Framingham risk ≥30%; net avoidance of 34 events/1000 patients) to SEK497,542 (versus atorvastatin 40 mg: Framingham risk ≥20%; net avoidance of 11 events/1000 patients) over a lifetime horizon. Probabilistic sensitivity analyses indicated that at a willingness-to-pay threshold of SEK500,000/QALY, rosuvastatin 20 mg would be cost-effective for approximately 75%-85% of simulations relative to atorvastatin or simvastatin 40 mg. Sensitivity analyses indicated the findings to be robust.

Conclusion: Rosuvastatin 20 mg is cost-effective over a lifetime horizon compared with generic simvastatin or atorvastatin 40 mg in patients at high cardiovascular risk in Sweden.

No MeSH data available.