Cost-effectiveness of simvastatin versus cholestyramine: results for Sweden

Cost-effectiveness ratios were estimated for each of 2 plasma cholesterol-lowering drug therapies, the HMG-CoA reductase inhibitor simvastatin and the well established cholestyramine, in comparison with a nonpreventive drug treatment alternative. The study was confined to Swedish men (aged 37 to 64 years at start of therapy) with total serum cholesterol levels above 6.2 mmol/L who were free of coronary artery disease (CAD). Costs included expected direct costs of plasma cholesterol-lowering treatment less expected savings resulting from preventing CAD. Effects were defined as changes in life expectancy. A discount rate of 5% and Swedish kronor (SEK) 1988 prices were used. The impact on CAD risks was calculated using multivariate logistic risk estimates from the Framingham Heart Study; Swedish estimates were used to calculate intervention costs and changes in healthcare costs. Over the range of cholesterol levels examined (6.2 to 9.8 mmol/L), simvastatin was consistently more cost-effective than cholestyramine.