Age and gender influence cost-effectiveness of initiating lipid-lowering drugs

הסקירה באדיבות מדיקונטקסט:Last Updated: 2001-07-18 18:18:11 EDT (Reuters Health)

LONDON (Reuters Health) – Age- and gender-based cut-off values should be used when determining the cost-effectiveness of initiating cholesterol-lowering drugs for the prevention of coronary heart disease.

In a study reported in the June issue of the European Heart Journal, Dr. Magnus Johannesson, from the Stockholm School of Economics, estimated the coronary risk level at which it would be cost-effective to initiate cholesterol-lowering drugs for primary prevention of coronary heart disease.

Dr. Magnus found that the appropriate coronary risk level varied with age and gender. Assuming that society is willing to pay $60,000 per quality-adjusted life-year (QALY), 35-year-old, 50-year-old, and 70-year-old men would need to have 5-year coronary heart disease risks exceeding 2.4%, 4.6%, and 10.4%, respectively, for treatment to be cost-effective. In women, the corresponding values were 2.0%, 3.5%, and 9.1%.

The current findings can "serve as a basis for developing treatment guidelines for cholesterol lowering in primary prevention based on cost-effectiveness," Dr. Magnus notes. "By comparing the absolute risk of a patient with the risk cut-off value for that age and gender it can be determined if cholesterol-lowering drug treatment is cost effective," he adds.

A problem with some current cholesterol-lowering guidelines, such as those set forth by the European Society of Cardiology, "from a cost-effectiveness viewpoint, is that the risk cut-off for treatment is independent of age and gender," Dr. Magnus points out. "The guidelines seem overly conservative as a basis for treatment decisions in younger and middle-aged men and women."

Eur Heart J 2001;22:919-925.

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