Pharmacoeconomic assessment of HMG-CoA reductase inhibitor therapy: An analysis based on the CURVES study

We conducted a post hoc pharmacoeconomic analysis of a multicenter, open-la bel, randomized, parallel-group, 8-week efficacy-safety comparison of five HMG-CoA reductase inhibitors-atorvastatin, fluvastatin, lovastatin, pravast atin, and simvastatin. The 534 patients requiring cholesterol-lowering ther apy took the drugs for 8 weeks with 15 different regimens. Low-density lipo protein (LDL) was measured after 6 weeks of diet (baseline) and after 8 wee ks of treatment with a study drug. At dosages of 10, 20, and 40 mg/day, ato rvastatin was associated with significantly greater reductions in LDL than equivalent dosages of the other agents. Cost-effectiveness calculated as th e annual acquisition cost/percentage LDL reduction was greatest with atorva statin 10 mg ($17.96), fluvastatin 40 mg ($19.83), atorvastatin 20 mg ($22. 85), and atorvastatin 40 mg ($24.96). All other dosages were above $25.00/y ear/percentage LDL reduction. Atorvastatin was the most cost-effective HMG- CoA reductase inhibitor. Fluvastatin 40 mg/day also had a favorable cost:ef fectiveness ratio but lowered LDL only by 23%.