Cost-Effectiveness Analyses
Authors: Lisa A. Prosser, Aaron A. Stinnett, Lee Goldman, Milton C. Weinstein
Journal: Annals of Internal Medicine (2001)

Letters4 September 2001Cost-Effectiveness AnalysesLisa A. Prosser, PhD, Aaron A. Stinnett, PhD, Lee Goldman, MD, MPH, and Milton C. Weinstein, PhDLisa A. Prosser, PhDHarvard Medical School; Boston, MA 02215 (Prosser)University of Alabama at Birmingham; Birmingham, AL 35294 (Stinnett)University of California, San Francisco; San Francisco, CA 94143 (Goldman)Harvard School of Public Health; Boston, MA 02115 (Weinstein)Search for more papers by this author, Aaron A. Stinnett, PhDHarvard Medical School; Boston, MA 02215 (Prosser)University of Alabama at Birmingham; Birmingham, AL 35294 (Stinnett)University of California, San Francisco; San Francisco, CA 94143 (Goldman)Harvard School of Public Health; Boston, MA 02115 (Weinstein)Search for more papers by this author, Lee Goldman, MD, MPHHarvard Medical School; Boston, MA 02215 (Prosser)University of Alabama at Birmingham; Birmingham, AL 35294 (Stinnett)University of California, San Francisco; San Francisco, CA 94143 (Goldman)Harvard School of Public Health; Boston, MA 02115 (Weinstein)Search for more papers by this author, and Milton C. Weinstein, PhDHarvard Medical School; Boston, MA 02215 (Prosser)University of Alabama at Birmingham; Birmingham, AL 35294 (Stinnett)University of California, San Francisco; San Francisco, CA 94143 (Goldman)Harvard School of Public Health; Boston, MA 02115 (Weinstein)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-5-200109040-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Clark that it is often relevant to differentiate between the decision to tailor therapy once treatment has been initiated and the decision to initiate treatment that we evaluated. In our cost-effectiveness analysis, we modeled dosages and lipid levels achieved by using data from observed practices in randomized clinical trials of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins), rather than on treatment guidelines for actual practice. For primary prevention, we used data from several large-scale trials that used a dosage of 40 mg of pravastatin per day (1-3). For secondary prevention, our analysis modeled a strategy ...References1. Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW, et al . Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med. 1995;333:1301-7. [PMID: 7566020] CrossrefMedlineGoogle Scholar2. Jukema JW, Bruschke AV, van Boven AJ, Reiber JH, Bal ET, Zwinderman AH, et al . Effects of lipid lowering by pravastatin on progression and regression of coronary artery disease in symptomatic men with normal to moderately elevated serum cholesterol levels. The Regression Growth Evaluation Statin Study (REGRESS). Circulation. 1995;91:2528-40. [PMID: 7743614] CrossrefMedlineGoogle Scholar3. Salonen R, Nyyssönen K, Porkkala E, Rummukainen J, Belder R, Park JS, et al . Kuopio Atherosclerosis Prevention Study (KAPS). A population-based primary preventive trial of the effect of LDL lowering on atherosclerotic progression in carotid and femoral arteries. Circulation. 1995;92:1758-64. [PMID: 7671358] CrossrefMedlineGoogle Scholar4. . Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383-9. [PMID: 7968073] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Harvard Medical School; Boston, MA 02215 (Prosser)University of Alabama at Birmingham; Birmingham, AL 35294 (Stinnett)University of California, San Francisco; San Francisco, CA 94143 (Goldman)Harvard School of Public Health; Boston, MA 02115 (Weinstein) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Cholesterol-Lowering Therapies according to Selected Patient Characteristics Lisa A. Prosser , Aaron A. Stinnett , Paula A. Goldman , Lawrence W. Williams , Maria G.M. Hunink , Lee Goldman , and Milton C. Weinstein Cost-Effectiveness Analyses Charles M. Clark Jr Metrics 4 September 2001Volume 135, Issue 5Page: 382-383KeywordsCholesterolLipidsLow density lipoproteinMedical risk factorsPopulation statisticsPrevention, policy, and public healthStatinsSurvival analysisTreatment guidelines ePublished: 4 September 2001 Issue Published: 4 September 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...