Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients
Issued Date
2024-12-01
Resource Type
ISSN
11102608
eISSN
2090911X
Scopus ID
2-s2.0-85190393215
Journal Title
Egyptian Heart Journal
Volume
76
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Egyptian Heart Journal Vol.76 No.1 (2024)
Suggested Citation
Dewi P.E.N., Thavorncharoensap M., Rahajeng B. Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients. Egyptian Heart Journal Vol.76 No.1 (2024). doi:10.1186/s43044-024-00478-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/98054
Title
Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients
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Author's Affiliation
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Abstract
Background: Post-hospitalized acute coronary syndrome (ACS) patients in Indonesia National Insurance does not pay for the use of high-intensity statin (HIS) for secondary prevention after ACS hospitalization. Moreover, a cost–utility analysis needs to be conducted to evaluate the cost-effectiveness of prescribing HIS and low-to-moderate-intensity statin (LMIS) per quality-adjusted life year (QALY). This study aimed to estimate the cost–utility of long-term HIS treatment in post-hospitalized ACS patients in Indonesia compared to current practice. Results: This study compared the economic outcomes of long-term HIS and LMIS in Indonesian post-hospitalized ACS patients. A lifetime Markov model predicted ACS-related events, costs, and QALY from a payer perspective. A systematic review estimated treatment-specific event probabilities, post-event survival, health-related quality of life, and Indonesia medical-care expenses from published sources. This study conducted probabilistic sensitivity analysis (PSA) using 1000 independent Monte Carlo simulations and a series of one-way deterministic sensitivity analyses utilizing a tornado diagram. The economic evaluation model proved that intensive HIS treatment can increase per-patient QALYs and care expenditures compared to LMIS. The use of HIS among post-hospitalized ACS patients had ICER 31.843.492 IDR per QALY gained, below the Indonesia willingness-to-pay (WTP) for terminal disease and life-saving treatment. Conclusion: From the Indonesia payer perspective, using HIS for post-hospitalized ACS patients in Indonesia is cost-effective at 31.843.492 IDR per QALY gained.