IngentaConnect Cost-Effectiveness Analysis of n-3 Polyunsaturated Fatty Acids (P...

Abstract:

Objective: To estimate the cost effectiveness of treatment with n-3 polyunsaturated fatty acids (PUFA) for secondary prevention after myocardial infarction (MI).

Design and setting: The cost-effectiveness analysis of n-3 PUFA treatment after MI was based on morbidity and mortality data and the use of resources obtained prospectively during the 3.5 year follow-up period of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto (GISSI)-Prevenzione study. The cost-effectiveness analysis took into account the incremental number of life-years gained and the incremental costs for hospital admissions, diagnostic tests and drugs, applying a 5% discount rate. The value for money of n-3 PUFA treatment was assessed using the cost-effectiveness ratio and the number needed to treat (NNT) approach.

Perspective: Third-party payer.

Main outcome measures and results: The incremental cost-effectiveness ratio for n-3 PUFA in the basecase scenario was 24 603 euro (EUR, 1999 values) per life-year gained (95% confidence interval: 22 646 to 26 930). Sensitivity analysis included the analysis of extremes, producing estimates varying from EUR15 721 to EUR52 524 per life-year gained. 172 patients would need to be treated per year with n-3 PUFA, at an annual cost of EUR68 000, in order to save 1 patient. This is comparable with the NNT value, and associated annual cost for simvastatin, but less costly than that for pravastatin.

Conclusions: The cost effectiveness of long term treatment with n-3 PUFA is comparable with other drugs recently introduced in the routine care of secondary prevention after MI. Since the clinical benefit provided by n-3 PUFA is additive, this therapy should be added to the established routine practice, with additive costs.

Keywords: Anti ischaemics, therapeutic use; Cost effectiveness; Myocardial infarction, treatment; Omega 3 fatty acid, therapeutic use; Pharmacoeconomics; Unsaturated fatty acids, therapeutic use

Document Type: Original article

Affiliations: 1: Department of Cardiovascular Research, Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milano, Italy 2: Laboratory of Health Services Research, Istituto di Ricerche Farmacologiche ‘Mario Negri’, Milano, Italy 3: Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro, Italy 4: Cardiology Department, San Gerardo Hospital, Monza, Italy

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Cost-Effectiveness Analysis of n-3 Polyunsaturated Fatty Acids (PUFA) after Myocardial Infarction: Results from Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto (GISSI)-Prevenzione Trial