Effect of lovastatin on cardiovascular resource utilization end costs in the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)

This cast-consequences analysis of the Air Force/Texas Coronary Atheroscler osis Prevention Study compares the costs of lovastatin treatment with the c asts of cardiovascular hospitalizations and procedures. The cost of lovasta tin treatment was defined as the average retail price and the cast of drug safety monitoring and adverse experiences. Costs were determined by actual rates of hospitalizations and procedures. Within a trial, lovastatin treatm ent cost approximately $4,654/patient. Lovastatin treatment significantly r educed the cumulative rate of cardiovascular hospitalizations and procedure s (P = 0.002). Over the duration of the study, the cumulative number of car diovascular hospitalizations and related therapeutic procedures was signifi cantly reduced by 29%. The time to first cardiovascular-related hospitaliza tion or procedure was significantly extended by lovastatin (p = 0.002). Lov astatin reduced the frequency of cardiovascular hospitalization (28%), and cardiovascular therapeutic (32%) and diagnostic procedures (23%). Among the rapeutic procedures, treatment reduced coronary artery bypass graft surgery by 19% and percutaneous transluminal coronary angioplasty by 37%. Total ca rdiovascular-related hospital days were reduced by 26% (p = 0.025). The bet ween-group offset in direct medical costs was $524, which resulted in a 11% cost offset of lovastatin therapy over the mean study duration of 5.2 year s. Lovastatin provides meaningful reductions in cardiovascular-related reso urce utilization and reductions in direct cardiovascular-related costs asso ciated with the onset of coronary disease. (C) 2000 by Excerpta Medica, Inc .