COST-EFFECTIVENESS OF PHARMACOTHERAPY BAS ED ON THE EXAMPLE OF PRAVASTATIN - SOCIOECONOMIC ANALYSIS OF CSE-INHIBITION IN PATIENTS WITH CAD

Background: Decision makers in the field of health services are increa singly forced to identify and realise the grounds for spendings and sa vings. Therefore, preventive measures of cardiovascular diseases are b ecoming more and more scrutinized. The present analysis is answering t he question: Is secondary preventive lipid-lowering therapy with a cho lesterol-synthesis-enzyme-(CSE-)inhibitor in patients with manifest co ronary heart disease cost-effective in comparison already proven medic al interventions? Methods: The cost-effectiveness-analysis with the en dpoint costs per life years saved had been chosen as a form of evaluat ion. The study is a retrospective analysis. clinical data have been ta ken from the already published double blinded randomised, placebo cont rolled PLAC-I- and -II-studies as well as from the PLAC-Meta-Analysis. The cost estimate (costs of myocardial infarction, stroke and cost th erapy with pravastatin) were based on the perspective of the German st atutory sick funds. Results: With the reduced probability of a fatal m yocardial infarction or a stroke in the group treated with pravastatin there are cost offsets of DM 2,400. This figure is opposed to an addi tional expenditure of about DM 6,900,- for the CSE-inhibitor. The calc ulation of the effectiveness resulted in an additional life expectancy of 0.28 years in the pravastatin cohorts in comparison with the group treated with placebo over an observation period of 3 years. The costs per life year saved are approximately DM 16,000,-. Conclusion: The pr eventive use of pravastatin in patients with coronary heart disease ca n be estimated as cost-effective as compared with other medical interv entions.