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Cost-effectiveness and cost-utility analysis of OTC use of simvastatin 10 mg for the primary prevention of myocardial infarction in Iranian men.

Amirsadri M, Hassani A - Daru (2015)

Bottom Line: Two measures of benefits were used in the model; Quality-Adjusted-Life-Years (QALYs) for the CUA and Life-Years-Gained (LYG) for the CEA.No threshold has been determined in Iran for the cost-effectiveness of health-related interventions.However, according to the recommendation of WHO, this intervention can be considered highly cost-effective as its ICER is far less than the reported GDP per capita for Iran by World bank in 2013 ($4763).

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. amirsadri@pharm.mui.ac.ir.

ABSTRACT

Background: Several clinical trials and meta-analyses have shown the advantageous effects of statins in populations with different levels of cardiovascular disease (CVD) risk. Considering the increasing cardiovascular risk among the Iranian population, the cost-effectiveness of the use of simvastatin 10 mg, as an Over-The-Counter (OTC) drug, for the primary prevention of myocardial infarction (MI) was evaluated in this modeling study, from the payer's perspective. The target population is a hypothetical cohort of 45-year CVD healthy men with an average (15%) 10-year CVD risk.

Methods: A semi-Markov model with a life-long time horizon was developed to evaluate the Cost-Utility-Analysis (CUA) and Cost-Effectiveness-Analysis (CEA) of the use of OTC simvastatin 10 mg compared to no-drug therapy. Two measures of benefits were used in the model; Quality-Adjusted-Life-Years (QALYs) for the CUA and Life-Years-Gained (LYG) for the CEA. To examine the robustness of the results, one-way sensitivity analysis and probabilistic sensitivity analysis were applied to the model.

Results: For the base-case scenario with a discount rate of 0% the estimated ICERs were 1113 USD/QALY and 935USD/LYG per patient (using governmental tariffs). No threshold has been determined in Iran for the cost-effectiveness of health-related interventions. However, according to the recommendation of WHO, this intervention can be considered highly cost-effective as its ICER is far less than the reported GDP per capita for Iran by World bank in 2013 ($4763).

Conclusions: This modeling study showed that the use of an OTC low dose statin (simvastatin 10 mg) for the primary prevention of myocardial infarction (MI) in 45-year men with a 10-year CVD risk of 15% could be considered highly cost-effective in Iran, as it meets the WHO threshold of the annual GDP per capita ($4763).

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Related in: MedlinePlus

CEAC for the base-case scenario (governmental tariffs)
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Fig8: CEAC for the base-case scenario (governmental tariffs)

Mentions: FigureĀ 8 shows the CEAC for the base-case scenario, based on the QALY values for OTC statin therapy when compared to no-drug therapy.Fig. 8


Cost-effectiveness and cost-utility analysis of OTC use of simvastatin 10 mg for the primary prevention of myocardial infarction in Iranian men.

Amirsadri M, Hassani A - Daru (2015)

CEAC for the base-case scenario (governmental tariffs)
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4697320&req=5

Fig8: CEAC for the base-case scenario (governmental tariffs)
Mentions: FigureĀ 8 shows the CEAC for the base-case scenario, based on the QALY values for OTC statin therapy when compared to no-drug therapy.Fig. 8

Bottom Line: Two measures of benefits were used in the model; Quality-Adjusted-Life-Years (QALYs) for the CUA and Life-Years-Gained (LYG) for the CEA.No threshold has been determined in Iran for the cost-effectiveness of health-related interventions.However, according to the recommendation of WHO, this intervention can be considered highly cost-effective as its ICER is far less than the reported GDP per capita for Iran by World bank in 2013 ($4763).

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, Iran. amirsadri@pharm.mui.ac.ir.

ABSTRACT

Background: Several clinical trials and meta-analyses have shown the advantageous effects of statins in populations with different levels of cardiovascular disease (CVD) risk. Considering the increasing cardiovascular risk among the Iranian population, the cost-effectiveness of the use of simvastatin 10 mg, as an Over-The-Counter (OTC) drug, for the primary prevention of myocardial infarction (MI) was evaluated in this modeling study, from the payer's perspective. The target population is a hypothetical cohort of 45-year CVD healthy men with an average (15%) 10-year CVD risk.

Methods: A semi-Markov model with a life-long time horizon was developed to evaluate the Cost-Utility-Analysis (CUA) and Cost-Effectiveness-Analysis (CEA) of the use of OTC simvastatin 10 mg compared to no-drug therapy. Two measures of benefits were used in the model; Quality-Adjusted-Life-Years (QALYs) for the CUA and Life-Years-Gained (LYG) for the CEA. To examine the robustness of the results, one-way sensitivity analysis and probabilistic sensitivity analysis were applied to the model.

Results: For the base-case scenario with a discount rate of 0% the estimated ICERs were 1113 USD/QALY and 935USD/LYG per patient (using governmental tariffs). No threshold has been determined in Iran for the cost-effectiveness of health-related interventions. However, according to the recommendation of WHO, this intervention can be considered highly cost-effective as its ICER is far less than the reported GDP per capita for Iran by World bank in 2013 ($4763).

Conclusions: This modeling study showed that the use of an OTC low dose statin (simvastatin 10 mg) for the primary prevention of myocardial infarction (MI) in 45-year men with a 10-year CVD risk of 15% could be considered highly cost-effective in Iran, as it meets the WHO threshold of the annual GDP per capita ($4763).

Show MeSH
Related in: MedlinePlus