[Cost-effectiveness of atorvastatin in the early treatment of acute coronary syndromes in Germany based on the MIRACL study].

Background And Purpose: Cardiovascular diseases are the leading cause of death in Germany and have a huge impact on the resource consumption. Therefore, cost-effectiveness of medical therapies must be evaluated and taken into consideration. The purpose of this study is to assess the short-term healthcare costs associated with intensive lipid lowering with atorvastatin (Sortis, Pfizer) initiated within 24-96 h after the onset of acute coronary syndromes (ACS) in patients from Germany.

Study Design: Model-based, cost-effectiveness analysis.

Methods: Clinical outcome data from the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study and cost data were used to compare the total expected 16-week cost per patient on atorvastatin 80 mg/day versus placebo. Only direct costs were taken into consideration. All direct medical costs were based on the average values of 116 hospitals in Germany, which were published in December 2002.

Perspective: The perspective of the German hospitals for the year 2004 was taken.

Results: The total calculated cost was euro 1,750 per patient in the placebo cohort and euro 1,910 per patient in the atorvastatin cohort, resulting in incremental cost of euro 161 per patient in the atorvastatin group. The cost per event avoided was euro 4,195. Over 40% of the cost of atorvastatin treatment was offset within 16 weeks by the cost savings resulting from the reduction in the number of events in the atorvastatin cohort compared to the placebo cohort. The validity of this result was substantiated through extensive sensitivity analyses.

Conclusion: The application of atorvastatin administered early after ACS is cost-effective, and the clinical benefits are available through marginal additional cost.