Abstract
Objective: The pharmacoeconomics of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (pravastatin) therapy were evaluated using data from an open-labeled, randomized, controlled trial (PCS: Prevention of Coronary Sclerosis study) with a two-year follow-up period.
Methods: Patients with a serum total cholesterol concentration of between 180 and 219mg/dL at baseline were randomly assigned to two groups: the pravastatin group (n=54) and the group that did not receive cholesterol-lowering drugs (no-pravastatin group, n=66). A cost-minimization analysis and a cost-effectiveness analysis were then performed from the perspective of a health insurance company, using insurance information obtained from the subjects. In the cost-minimization analysis, the expected costs associated with percutaneous transluminal coronary angioplasty (PTCA) and the pravastatin prescription were compared; the total medication costs between the two groups were also compared. In the cost-effectiveness analysis, the estimated savings per event-free year were calculated.
Results: The median cost of a PTCA procedure was \1, 323, 492. The expected insurance cost for two years was \182, 532 per patient in the pravastatin group and \224, 444 per patient in the no-pravastatin group. The cost-minimization analysis showed that the cost of healthcare for the no-pravastatin group was higher than that for the pravastatin group. The mean total cost of medication was \729, 849 per patient in the pravastatin group and \989, 606 per patient in the no-pravastatin group. The cost-effectiveness ratio for coronary heart disease was \2, 766, 994.
Conclusion: Pravastatin therapy in normocholesterolemic patients with coronary sclerosis seems to have an excellent pharmacoeconomic profile.
