COST-EFFECTIVENESS OF CHOLESTEROL-LOWERING - RESULTS FROM THE SCANDINAVIAN SIMVASTATIN SURVIVAL STUDY (4S)

An analysis of the cost-effectiveness of simvastatin was conducted, ba sed on the Scandinavian Simvastatin Survival Study (4S). The total cos t of hospitalization in the placebo group was 52 . 8 million Swedish k ronor (SEK) (pound 5 . 15 million), compared with SEK 36 . 0 million ( pound 3 . 51million) in the simvastatin group. This amounts to a 32% r eduction, or a saving of SEK 16 . 8 million (pound 1 . 6 million) or S EK 7560 (pound 738) per patient. The net cost per patient for the dura tion of the study (5 . 4 years) was SEK 13 540 (pound 1324). Simvastat in treatment saved an estimated 0 . 377 undiscounted life years (0 . 2 40 life years discounted at 5% per annum). The cost of simvastatin the rapy per discounted life-year saved was therefore SEK 56 400 (pound 55 02). Sensitivity analysis, examining the effect of different life expe ctancies, costs of initiation and monitoring of simvastatin therapy, a nd discount rates, showed the results to be stable. Conclusion The cos t per life-year saved of simvastatin in the treatment of post-myocardi al infarction and angina patients, as determined from 4S data, is well within the range normally considered cost-effective.