Evidence map›Paper›PMID 10539400›Full record

ArticlePharmacoEconomics1999

Choice of cost-effectiveness measure in the economic evaluation of cholesterol-modifying pharmacotherapy. An illustrative example focusing on the primary prevention of coronary heart disease in Canada.

S Morris, E Godber

Abstract read
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In one paragraph

Article in PharmacoEconomics, 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

S MorrisDepartment of Economics, City University, London, England. s.morris@city.ac.uk
E Godber

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effect of using different cost-effectiveness measures in the economic evaluation of cholesterol-modifying pharmacotherapy. DESIGN AND

settingAn economic model was used to examine the extent to which the relative cost effectiveness of cholesterol-modifying agents varies depending upon the cost-effectiveness measure used. The perspective taken was that of the Canadian public healthcare system. PATIENTS: Individuals without coronary heart disease (CHD) with low-density lipoprotein cholesterol (LDL-C) levels in excess of 190 mg/dl.

interventionsCholesterol-modifying pharmacotherapies available in Canada. MAIN OUTCOME MEASURES AND

resultsCost per 1% reduction in LDL-C level; incremental cost per life-year gained; least-cost agent achieving the LDL-C reduction required to meet the target level of 160 mg/dl; incremental cost per life-year gained of agents reaching the target LDL-C level of 160 mg/dl relative to no therapy; incremental cost per life-year gained of agents achieving the target LDL-C level of 160 mg/dl relative to the least-cost agent reaching the target. Each cost-effectiveness measure had a different informational content to decision-makers, both in terms of the usefulness of the information they provided, and in terms of the extent to which they showed one agent to be more cost effective than another. The most cost-effective treatment regimens were fluvastatin 20 mg per day, fluvastatin 40 mg per day, atorvastatin 10 mg per day and atorvastatin 20 mg per day, depending on the pretreatment LDL-C level and the cost-effectiveness measure used.

conclusionsWe recommend that the cost effectiveness of cholesterol-modifying pharmacotherapy be measured using incremental cost per life-year gained in reaching a predefined target LDL-C level.

Indexed as

Anticholesteremic AgentsCholesterol, LDLCoronary DiseaseCost-Benefit AnalysisHumansRisk FactorsAnticholesteremic AgentsCholesterol, LDL

Identifiers

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.