Cost-effectiveness of cholesterol lowering: Results from the Scandinavian Simvastatin Survival Study (4S)

Abstract
An analysis of the cost-effectiveness of simvastatin was conducted, based on the Scandinavian Simvastatin Survival Study (4S). The total cost of hospitalization in the placebo group was 5·28 million Swedish kronor (SEK) (£5·l5 million), compared with SEK 36·0 million (£3·51 million) in the simvastatin group. This amounts to a 32% reduction, or a saving of SEK 16·8 million (£1·6 million) or SEK 7560 (£738) per patient. The net cost per patient for the duration of the study (5·4 years) was SEK 13 540 (£1324). Simvastatin treatment saved an estimated 0·377 undiscounted life years (0·240 life years discounted at 5% per annum). The cost of simvastatin therapy per discounted life-year saved was therefore SEK 56 400 (£5502) Sensitivity analysis, examining the effect of different life expectancies, costs of initiation and monitoring of simvastatin therapy, and discount rates, showed the results to be stable.

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