Cost-effectiveness of pravastatin therapy for survivors of myocardial infarction with average cholesterol levels

Background The objective ci this study woe to assess the cost-effectiveness of pravastatin therapy in survivors of myocardial infarction with average cholesterol levels. Methods We performed a cost-effectiveness analysis based on actual clinical , cost, and health-related quality-of-life data from the Cholesterol and Re current Events (CARE) trial. Survival and recurrent coronary heart disease events were modeled from trial data in Markov models, with the use of diffe rent assumptions regarding the long-term benefit of therapy. Results Pravastatin therapy increased quality adjusted life expectancy at o n incremental cost of $16,000 to $32,000 per quality-adjusted life-year gai ned. In subgroup analyses, the cost-effectiveness of pravastatin therapy wa s more favorable for patients >60 years of age and for patients with pretre atment low-density lipoprotein cholesterol levels >125 mg/dL. Results were sensitive to the cost of pravastatin and to assumptions about long-term sur vival benefits from pravastatin therapy. Conclusions The cost-effectiveness of pravastatin therapy in survivors of m yocardial infarction with average cholesterol levels compares favorably wit h other interventions.