The Cost-Effectiveness Impact of a Preferred Agent HMG-CoA Reductase Inhibitor Policy in a Managed Care Population

OBJECTIVE: The purpose of this study was to analyze the economic and health outcomes of implementing a preferred agent (HMG-CoA) reductase inhibitor policy in a managed care population. DESIGN: A Markov model with three states was constructed: 1) alive with no cardiac or coronary heart disease (CHD), 2) alive with CHD; and, 3) dead. In the model patients can move from one state to another as a function of CHD risk factors and expected changes in the lipid levels secondary to therapy. Event rates for CHD-related hospitalizations are also predicted. Health care costs included hospitalization costs for CHD events and HMG-CoA drug costs. Risk factor data were collected on a random sample of 150 patients of the 3,500 managed care patients receiving HMG-CoA therapy. Outcomes were modeled until age 80. Results were generated for a baseline of one year before and six months after implementation of the policy. SETTING: Group practice managed care organization. PATIENTS: Patients receiving HMG-CoA reductase inhibit...