Cost-effectiveness of statins for primary prevention in newly diagnosed type 2 diabetes patients: An illustration for The Netherlands

Folgerdiena M. De Vries, Petra Denig, Sipke T. Visser, Eelko Hak, Maarten J. Postma

Research output: Contribution to journalMeeting AbstractAcademic

Abstract

Background: Patients with type 2 diabetes have an increased risk of cardiovascular events, which can be reduced by statin treatment. Objectives: The aim of this study is to determine if statin treatment for primary prevention started at the time of type 2 diabetes diagnosis is cost-effective, taking non-adherence and different age groups into account. Methods: A cost-effectiveness analysis has been performed using a Markov model with a time horizon of 10 years. The 10-years cardiovascular risk was estimated in a Dutch population of primary prevention patients with newly diagnosed diabetes from the GIANTT database (Groningen Initiative to Analyse Type 2 Diabetes Treatment) using the UKPDS risk engine. Statin adherence of a Dutch type 2 diabetes population was measured as pill days covered (PDC) in the IADB pharmacy research database. PDC of ≥ 80% and ≤ 20% were associated with full and no efficacy of the treatment. Cost-effectiveness was measured in costs per quality-adjusted life-year (QALY) from the healthcare payers perspective, also stratified for cardiovascular risk and age. A probabilistic sensitivity analysis was performed. Results: Characteristics of 4,683 primary prevention type 2 diabetes patients were inserted into the UKPDS risk engine. The mean 10-years risk of the population was 23% for coronary heart disease (CHD), 14% for fatal CHD, 10% for stroke and 2% for fatal stroke. PDC in the type 2 diabetes population was 81%, 77% and 75% in years one, two and three, respectively. In general, statin treatment was highly cost-effective at around €2,500 per QALY. Favorable cost-effectiveness was robust in sensitivity analysis. Differences in age and 10-years cardiovascular risk showed large differences in cost-effectiveness ranging from more than €800,000 per QALY to being cost saving. Conclusions: Statin treatment for primary prevention in patients newly diagnosed with type 2 diabetes is costeffective. Due to large differences in cost-effectiveness according to different risk groups, the efficiency of the treatment could be increased by focusing on patients with higher cardiovascular risk and higher ages.
Original languageEnglish
Pages (from-to)117-118
Number of pages2
JournalPharmacoepidemiology and Drug Safety
Volume22
Issue numbers1
Publication statusPublished - Oct-2013

Keywords

  • hydroxymethylglutaryl coenzyme A reductase inhibitor
  • statin (protein)
  • cost effectiveness analysis
  • primary prevention
  • non insulin dependent diabetes mellitus
  • diabetic patient
  • human
  • Netherlands
  • pharmacoepidemiology
  • risk management
  • risk
  • population
  • patient
  • cardiovascular risk
  • quality adjusted life year
  • data base
  • cerebrovascular accident
  • sensitivity analysis
  • pharmacy
  • pill
  • diabetes mellitus
  • high risk population
  • cost control
  • model
  • groups by age
  • ischemic heart disease
  • health care
  • diagnosis

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