Last update:
28-Dec-2007

OBJECTIVE To determine the cost-effectiveness of treatment with atorvastatin compared to simvastatin, generically priced, in achieving the NCEP ATP III LDL-cholesterol target levels in Greece.

METHOD To compare atorvastatin and simvastatin, a "targeted" titration model was used to estimate goal attainment effectiveness, the annual drug and titration cost and cost efficiency, based on the proportion of patients achieving NCEP ATP III LDL treatment targets. The model considers a cohort of 1,000 patients for each statin, using the LDL-lowering efficacy, by dose, of atorvastatin 10-40 mg and simvastatin 20-40 mg, and the distributions of NHANES-3 survey data to compute the percentage of patients in each of the three NCEP ATP III coronary risk levels. The doses used in the model are those available in Greece. A cost component analysis was explored by taking into account (a) drug expenses, (b) laboratory costs, and (c) the cost of outpatient visits. Further, in order to obtain a wider view of the cost variation that occurs in Greece, differences between public and private health services were included in the model.

RESULTS The percentage of patients receiving atorvastatin treatment and achieving the target levels of NCEP ATP III for LDL was 89.7% compared with 70% for patients receiving simvastatin. The total cost per patient achieving the target amounted, in the public sector, to € 689 for atorvastatin and € 808 for simvastatin, while the same cost in the private sector was € 1,726 and € 2,161, respectively.

CONCLUSIONS The results from the comparison of atorvastatin 10-40 mg with generically priced simvastatin 20-40 mg demonstrate that atorvastatin is clinically superior and a more cost-effective choice for treating patients, using NCEP ATP III treatment goals, compared to simvastatin, according to the modelling scenario and cost conditions analysed.

Key words: Cholesterol, Coronary disease, Cost, Effectiveness, Statins.