The cost-effectiveness of lipid lowering in patients with diabetes:: results from the 4S trial
The cost-effectiveness of lipid lowering in patients with diabetes:: results from the 4S trial
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DOI：
10.1007/s001250051441
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发表时间：
1999-11-01
期刊：
影响因子：
8.2
通讯作者：
Pedersen, TR
中科院分区：
文献类型：
--
作者：
Jönsson, B;Cook, JR;Pedersen, TR
目的/假设。本研究的目的是调查辛伐他汀在糖尿病患者的成本效益，使用前瞻性收集的结果数据从斯堪的纳维亚辛伐他汀生存研究。使用两种不同的分类方案确定糖尿病患者：临床病史（糖尿病，非糖尿病）和美国糖尿病协会新定义（糖尿病，空腹血糖受损，空腹血糖正常）。该分析基于从试验中前瞻性收集的心血管问题住院、研究药物利用和死亡率数据。使用瑞典（主要）和其他欧洲国家的成本估计辛伐他汀每生命年节省的增量成本。辛伐他汀治疗组因心血管问题住院的人数显著减少，在糖尿病亚组中差异最大。糖尿病组住院治疗的减少导致了大量的医院成本节省，抵消了67%至76%的药物成本（取决于所使用的分类）。对于糖尿病患者，使用瑞典成本，获得的每生命年成本估计值范围为1600欧元（基于临床病史）至3200欧元（基于美国糖尿病协会）。在其他评估的欧洲国家与辛伐他汀治疗表现出有利的成本效益比独立的差异，在当地的医疗单位costs.Conclusion/解释。对于糖尿病分类方案中的所有亚组，辛伐他汀治疗导致获得的每生命年成本估计值完全在通常认为具有成本效益的范围内。根据斯堪的纳维亚辛伐他汀生存研究，辛伐他汀治疗在糖尿病和非糖尿病心血管疾病患者中提供了良好的经济价值。
Aims/hypothesis. The purpose of this study is to investigate the cost-effectiveness of simvastatin in diabetic patients, using prospectively collected outcomes data from the Scandinavian Simvastatin Survival Study.Methods. Diabetic patients were identified using two different classifications schemes: Clinical history (diabetic, non-diabetic) and the new American Diabetes Association definition (diabetic, impaired fasting glucose, normal fasting glucose). The analysis is based on prospectively collected data from the trial on hospitalization for cardiovascular problems, study drug utilization and mortality. The incremental cost per life year saved with simvastatin is estimated using costs from Sweden (primary) and other European countries.Results. Hospitalizations for cardiovascular problems were considerably reduced with simvastatin therapy, with the greatest differences in the diabetic subgroups. Reductions in hospitalizations in the diabetic group resulted in substantial hospital cost savings that offset 67 to 76% of the drug cost (depending on the classification used). For the diabetic patients, the estimates of the cost per life-year gained ranged from 1600 Euros (based on clinical history) to 3200 Euros (based on American Diabetes Association) using Swedish costs. In the other evaluated European countries treatment with simvastatin showed a favourable cost-effectiveness ratio independent of differences in local health care unit costs.Conclusion/interpretation. For all subgroups in the diabetic classification schemes, treatment with simvastatin resulted in estimates of cost per life-year gained that were well within the range generally considered to be cost effective. Based on the Scandinavian Simvastatin Survival Study, simvastatin therapy provides good value for money in both diabetic and non-diabetic patients with cardiovascular disease.