Are the WOSCOPS clinical and economic findings generalizable to other populations? A case study for Belgium

Aims - As the West of Scotland Coronary Prevention Study (WOSCOPS) was cond ucted in Scotland, a country well-known for its high cardiovascular risk, t he generalizability of its findings on pravastatin's clinical and economic effects has been questioned. This study examines the legitimacy of this con cern, using Belgium as a case study. Methods and Results - Local information on the prevalence and clustering of risk factors in individual patients was used in a risk equation to estimat e the reference risk in Belgium. In contrast to prevailing beliefs, this ri sk was shown to coincide with the trial population's risk. As the relative risk reduction documented in atrial should apply across populations, the he alth benefits observed in WOSCOPS can clearly be extrapolated. This informa tion in combination with local costs was then used to assess the economic e fficiency of primary prevention with pravastatin in Belgium by means of a p reviously developed model. In parallel with the original estimates for the United Kingdom, the cost-effectiveness ratios remain well within the range of what is considered strong to moderate evidence for adoption and appropri ate utilization, over a wide range of input values. Conclusion - This study demonstrates that the clinical and economic finding s from WOSCOPS can indeed be generalized to other populations.