Analysis and comparison of the cost-effectiveness of statins according to the baseline low-density lipoprotein cholesterol level in Korea

What is known and objectiveThere are a few Korean studies on the economics of statins based on reduction in low-density lipoprotein cholesterol (LDL-C) data from other countries. This study aimed to analyse and compare the cost-effectiveness of statins according to the baseline LDL-C level in Korea. MethodsBetween January 2009 and December 2015, the data of patients who were prescribed statins for the first time were extracted from electronic medical records. We performed a cost-effectiveness analysis (CEA) based on the LDL-C reduction rate (CEA-RR) and target achievement rate. Results and discussionAmong high-intensity statins, the CEA-RR value of rosuvastatin (20 mg) was significantly lower than that of atorvastatin (40 mg) at all baseline LDL-C levels, except levels of 160-189 mg/dL. Additionally, at baseline LDL-C levels of 130-159 mg/dL, the CEA-RR value of rosuvastatin (20 mg) was three times lower than that of atorvastatin (40 mg) (91 25 $/% vs. 317 +/- 150 $/%, P < 0001). Among moderate-to-low-intensity statins, rosuvastatin (5 mg) showed the lowest CEA-RR value (40 +/- 06 $/%), and the value significantly increased for pitavastatin (2 mg) (80 +/- 06 $/%), atorvastatin (10 mg) (95 +/- 05 $/%), simvastatin (108 +/- 11 $/%) and pravastatin (40 mg) (115 +/- 09 $/%) in order (P < 00001). On changing from atorvastatin (10 mg) to atorvastatin (20 mg), the additional yearly cost was 160 and additional CEA-RR value was 274 $/%. On the other hand, on changing from atorvastatin (10 mg) to rosuvastatin (10 mg), the additional yearly cost was -163 and additional CEA-RR value was -18 $/%. What is new and conclusionWe successfully compared the cost-effectiveness of statins according to the baseline LDL-C level in Korea. It is expected that our findings will help clinical decision-making with regard to statin prescription, and this will help reduce national medical expenditure.