Cost of treating to a modified European atherosclerosis society LDL-C target - Comparison of atorvastatin with fluvastatin, pravastatin and simvastatin

Objective: To compare the costs of treating hypercholesterolaemic patients to a modified European Atherosclerosis Society low density lipoprotein cholesterol (LDL-C) target using atorvastatin, fluvastatin, pravastatin and simvastatin. Patients and Study Design: A total of 336 patients with hyperlipidaemia with coronary heart disease (CHD) and/or peripheral vascular disease (PVD) were enrolled in this randomised, 54-week, controlled trial. Therapy was initiated at recommended starting doses and titrated up in dose every 12 weeks until the LDL-C target was achieved. For patients not reaching LDL-C tar-get at the highest recommended dose of each statin, cholestyramine was added. Results: A significantly greater proportion of patients treated with atorvastatin achieved LDL-C target at any time during the study compared with patients treated with fluvastatin or pravastatin (p < 0.001 for each comparison), but not simvastatin (p = 0.135). Patients treated with atorvastatin achieved LDL-C target significantly faster (p < 0.005) at lower doses of study drug and required significantly fewer clinic visits than comparator statins. Consequently, mean total cost of care to reach LDL-C target was significantly lower with atorvastatin than with the other statins (p < 0.05; pound 501 versus pound 1130 for fluvastatin, pound 906 for pravastatin and pound 613 for simvastatin; pound, 1997). Conclusions: In patients with CHD and/or PVD, LDL-C target is achieved faster using fewer resources and at a significant cost saving with atorvastatin compared with fluvastatin, pravastatin or simvastatin.