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Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System

Overview of attention for article published in Arquivos Brasileiros de Cardiologia, January 2014
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Title
Cost-Effectiveness of High, Moderate and Low-Dose Statins in the Prevention of Vascular Events in the Brazilian Public Health System
Published in
Arquivos Brasileiros de Cardiologia, January 2014
DOI 10.5935/abc.20140173
Pubmed ID
Authors

Rodrigo Antonini Ribeiro, Bruce Bartholow Duncan, Patricia Klarmann Ziegelmann, Steffan Frosi Stella, Jose Luiz da Costa Vieira, Luciane Maria Fabian Restelatto, Carisi Anne Polanczyk

Abstract

Statins have proven efficacy in the reduction of cardiovascular events, but the financial impact of its widespread use can be substantial. To conduct a cost-effectiveness analysis of three statin dosing schemes in the Brazilian Unified National Health System (SUS) perspective. We developed a Markov model to evaluate the incremental cost-effectiveness ratios (ICERs) of low, intermediate and high intensity dose regimens in secondary and four primary scenarios (5%, 10%, 15% and 20% ten-year risk) of prevention of cardiovascular events. Regimens with expected low-density lipoprotein cholesterol reduction below 30% (e.g. simvastatin 10mg) were considered as low dose; between 30-40%, (atorvastatin 10mg, simvastatin 40 mg), intermediate dose; and above 40% (atorvastatin 20-80 mg, rosuvastatin 20mg), high-dose statins. Effectiveness data were obtained from a systematic review with 136,000 patients. National data were used to estimate utilities and costs (expressed as International Dollars - Int$). A willingness-to-pay (WTP) threshold equal to the Brazilian gross domestic product per capita (circa Int$11,770) was applied. Low dose was dominated by extension in the primary prevention scenarios. In the five scenarios, the ICER of intermediate dose was below Int$10,000 per QALY. The ICER of the high versus intermediate dose comparison was above Int$27,000 per QALY in all scenarios. In the cost-effectiveness acceptability curves, intermediate dose had a probability above 50% of being cost-effective with ICERs between Int$ 9,000-20,000 per QALY in all scenarios. Considering a reasonable WTP threshold, intermediate dose statin therapy is economically attractive, and should be a priority intervention in prevention of cardiovascular events in Brazil.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 2%
Netherlands 1 2%
Brazil 1 2%
Unknown 58 95%

Demographic breakdown

Readers by professional status Count As %
Student > Master 14 23%
Student > Postgraduate 9 15%
Student > Ph. D. Student 6 10%
Student > Bachelor 5 8%
Researcher 3 5%
Other 11 18%
Unknown 13 21%
Readers by discipline Count As %
Medicine and Dentistry 15 25%
Pharmacology, Toxicology and Pharmaceutical Science 9 15%
Social Sciences 4 7%
Nursing and Health Professions 3 5%
Chemistry 2 3%
Other 12 20%
Unknown 16 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 August 2015.
All research outputs
#10,867,845
of 13,643,660 outputs
Outputs from Arquivos Brasileiros de Cardiologia
#311
of 513 outputs
Outputs of similar age
#160,361
of 233,019 outputs
Outputs of similar age from Arquivos Brasileiros de Cardiologia
#1
of 1 outputs
Altmetric has tracked 13,643,660 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 513 research outputs from this source. They receive a mean Attention Score of 2.0. This one is in the 26th percentile – i.e., 26% of its peers scored the same or lower than it.
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