[show abstract][hide abstract] ABSTRACT: Objective. To assess the clinical and economic benefits of atorvastatin for Canadian patients with type 2 diabetes from the Canadian Ministry of Health perspective.Methods. A Markov cost-effectiveness model based on the clinical outcomes of the CARDS trial was populated with a hypothetical cohort of patients with type 2 diabetes and no history of cardiovascular (CV) events, receiving 10-mg/day atorvastatin or placebo. Model inputs were retrieved from published literature and public datasets. Time horizon was 5 years, with additional projections for 10 and 25 years. Deterministic and probabilistic sensitivity analyses were performed.Results. Over 5 years, patients treated with atorvastatin experienced fewer CV events, gained 0.02 quality-adjusted life years (QALYs) on a per patient basis, and had 1% fewer deaths compared with placebo, at an additional cost of Can$1,389/patient. The incremental cost-effectiveness of atorvastatin was $70,773/QALY [95% CI 33,981–195,914], CAN$12,687/QALY [95% CI dominant–CAN$66,048], and $1,362/QALY [95% CI dominant–CAN$49,432] at 5, 10, and 25 years respectively. The model was sensitive to variations in the hazard ratios for CV events, age, systolic blood pressure, and cholesterol levels.Conclusions. This study supports the cost-effectiveness of atorvastatin for primary prevention of major CV events in patients with type 2 diabetes.
Canadian Journal of Diabetes 01/2009; 33(4):363-374. · 0.46 Impact Factor
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