Economic Cost of Cardiovascular Disease in the United States 1997

1
Economic Cost of Cardiovascular Disease in the
United States (1997)
CHD (90.9 billion)
Total CVD (259.1 billion)
39
48
43
40
4
5
8
9
3
1
Hospital/nursing home
Physician/other professionals
Drugs
Home health/other medical durables
Lost productivity
AHA. 1997 Heart and Stroke Statistical Update.
2
Resource Utilization for Patients with CHD and/or
Peripheral Vascular Disease to Reach a Modified
EAS LDL-C Target
Atorvastatin Simvastatin Pravastatin
Fluvastatin (n140) (n66) (n72) (n58) Visits
(mean number) 4.6 5.6 6.9 7.0 Add on
cholestyramine 5 20 66 60 Cost
difference vs atorvastatin 22 more 80
more 126 more
Results from a 54-week, multicenter, open-label,
randomized, treat-to-target study of 336 patients
with CHD or peripheral vascular disease treated
to a modified EAS LDL-C target (lt110 mg/dL 2.63
mmol/L). Smith D et al. Clin Drug Invest
199917185193.
3
Resource Utilization for Patients to Reach NCEP
LDL-C Goals Study Design

• 662 patients were divided into 2 groups
  CHD/peripheral vascular disease group and CHD
  risk factor group
• Therapy atorvastatin, fluvastatin, lovastatin,
  and simvastatin. Initiated at starting doses with
  titration at 12-week intervals to a maximum of
  80 mg/day of atorvastatin and lovastatin or 40
  mg/day of fluvastatin and simvastatin with
  colestipol added, if necessary to attain NCEP
  guideline targets
• Duration 54 weeks
• Data collection resources and costs for office
  visits, laboratory, prescribed medication,
  treatment of adverse events attributed to study
  therapy

Koren MJ et al. Pharmacoeconomics 1998145970.
4
Resource Utilization for Patients with CHD to
Reach NCEP LDL-C Goals
Atorvastatin Simvastatin Lovastatin
Fluvastatin (n80) (n77) (n81) (n80) Visits
(mean number)1 5.7 6.5 6.6 7.4 Median dose2 20
mg/day 40 mg/day 80 mg/day 40 mg/day Add on
colestipol2 8 33 35 76 Cost difference vs
atorvastatin1 23 more 70 more 27 more
Results from a 54-week, multicenter, open-label,
randomized, treat-to-target study of 318 patients
with documented atherosclerosis. 1. Koren MJ et
al. Pharmacoeconomics 1998145970. 2. Brown AS
et al. J Am Coll Cardiol 199832665672.
5
Resource Utilization for Patients with Risk
Factors for CHD to Reach NCEP LDL-C Goals
Atorvastatin Simvastatin Lovastatin
Fluvastatin (n86) (n87) (n86) (n85) Visits
(mean number)1 4.0 5.6 5.5 6.8 Median dose2 10
mg/day 20 mg/day 40 mg/day 40 mg/day Add on
colestipol2 2 24 24 67 Cost difference vs
atorvastatin1 61 more 107 more 71 more
Results from a 54-week, multicenter, open-label,
randomized, treat-to-target study of 344 patients
with risk factors for CHD. 1. Koren MJ et al.
Pharmacoeconomics 1998145970. 2. Hunninghake D
et al. J Fam Pract 199847349356.