Cost of treating to a modified European atherosclerosis society LDL-C target - Comparison of atorvastatin with fluvastatin, pravastatin and simvastatin

Objective: To compare the costs of treating hypercholesterolaemic patients to a modified European Atherosclerosis Society low density lipoprotein chol esterol (LDL-C) target using atorvastatin, fluvastatin, pravastatin and sim vastatin. Patients and Study Design: A total of 336 patients with hyperlipidaemia wit h coronary heart disease (CHD) and/or peripheral vascular disease (PVD) wer e enrolled in this randomised, 54-week, controlled trial. Therapy was initi ated at recommended starting doses and titrated up in dose every 12 weeks u ntil the LDL-C target was achieved. For patients not reaching LDL-C tar-get at the highest recommended dose of each statin, cholestyramine was added. Results: A significantly greater proportion of patients treated with atorva statin achieved LDL-C target at any time during the study compared with pat ients treated with fluvastatin or pravastatin (p < 0.001 for each compariso n), but not simvastatin (p = 0.135). Patients treated with atorvastatin ach ieved LDL-C target significantly faster (p < 0.005) at lower doses of study drug and required significantly fewer clinic visits than comparator statin s. Consequently, mean total cost of care to reach LDL-C target was signific antly lower with atorvastatin than with the other statins (p < 0.05; pound 501 versus pound 1130 for fluvastatin, pound 906 for pravastatin and pound 613 for simvastatin; pound, 1997). Conclusions: In patients with CHD and/or PVD, LDL-C target is achieved fast er using fewer resources and at a significant cost saving with atorvastatin compared with fluvastatin, pravastatin or simvastatin.