Cost Effectiveness of Statin Drug Therapy in the Lowering of Cholesterol in Patients at Dwight D. Eisenhower Army Medical Center.

摘要

Selecting efficient treatment strategies requires the careful consideration of both the effectiveness and cost of therapy. With over $1,150, 000 expended on statin drugs at Eisenhower Army Medical Center, the utilization of a cost- effectiveness analysis tool, cost-effectiveness ratio (CER) , was employed to evaluate the success of cholesterol lowering on those patients undergoing treatment. This retrospective quantitative study determined that the most cost effective stat in LDL-C reduction used during FY 99 was pravastatin (CER=14.2) . By applying the same cost-effectiveness measurement tool, cerivastatin (CER=4.7) proved significantly more cost effective than pravastatin at LDL-C reduction. The final objective of this study measured the effect of statin drug conversions on a patient's LDL-C level due to formulary limitations. Comparison of statin drug conversion on LDL-C levels revealed that drug conversion did not cause a significant increase in the LDL-C levels of patients (p=. 113 for atorvastatin to simvastatin conversion, p . 072 for pravastatin to simvastatin conversion, and p .331 for pravastatin to cerivastatin conversion) . In addition, the study determined that these conversions did not cause a significant change in the ability for a patient to reach their LDL-C goal (p . 571 for atorvastatin to simvastatin conversion, p . 579 for pravastatin to simvastatin conversion, and p .068 for pravastatin to cerivastatin conversion) . For the health care administrator, this project supports the ideal that sound business practices, which simultaneously consider clinical outcomes, can successfully maximize the utilization of scarce health care resources.