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Statins: cost analysis in Indian scenario from eight major clinical trials

J Sanmukhani1, V Shah

  • 1Department of Pharmacology, Government Medical College, Bhavnagar, Gujarat- 364001, India. jayesh_sanmukhani@yahoo.co.in

Journal of Postgraduate Medicine
|August 27, 2010
PubMed

Insights

Statins are effective in reducing coronary heart disease (CHD) deaths. This study found statin use is more cost-effective for secondary prevention than primary prevention, with varying costs per event averted.

Area of Science:

  • Cardiovascular Medicine
  • Health Economics
  • Pharmacoeconomics

Background:

  • Coronary heart disease (CHD) is a leading cause of mortality in India, particularly among younger populations.
  • Statins have demonstrated efficacy in reducing CHD mortality in clinical trials.
  • Understanding the cost-effectiveness of statins is crucial for public health policy in India.

Purpose of the Study:

  • To determine the cost-effectiveness ratio (CER) of statins for preventing major coronary events and deaths.
  • To analyze the CER of statins across different clinical settings (primary, secondary, and high-risk prevention).
  • To compare the cost-effectiveness of statins based on data from major clinical trials.

Main Methods:

  • Systematic selection of key clinical trials including WOSCOPS, AFCAPS, ASCOT-LLA (primary prevention), CARE, LIPID, 4S (secondary prevention), and HPS, PROSPER (high-risk patients).
  • Calculation of absolute risk reduction and Number Needed to Benefit (NNTB) for various subgroups.
  • Determination of CER for branded and generic statins using Indian drug pricing data.

Main Results:

  • CER varied significantly across studies and patient groups, ranging from Rs. 6.9 lacs to Rs. 52.4 lacs per event averted or death avoided.
  • Primary prevention generally showed higher CERs compared to secondary prevention.
  • Specific CERs were reported for major coronary events averted and CHD deaths avoided in different trial settings.

Conclusions:

  • Statin therapy is associated with higher costs in primary prevention compared to secondary prevention.
  • Further research is recommended to validate these findings and inform health policy decisions regarding statin use.
  • The cost-effectiveness of statins necessitates careful consideration within the Indian healthcare context.
Abstract

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