Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients
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-effect...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2024-04-01
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| Series: | The Egyptian Heart Journal |
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| Online Access: | https://doi.org/10.1186/s43044-024-00478-2 |
| _version_ | 1797199346276499456 |
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| author | Pramitha Esha Nirmala Dewi Montarat Thavorncharoensap Bangunawati Rahajeng |
| author_facet | Pramitha Esha Nirmala Dewi Montarat Thavorncharoensap Bangunawati Rahajeng |
| author_sort | Pramitha Esha Nirmala Dewi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-24T07:14:17Z |
| format | Article |
| id | doaj.art-90dae9d0f5d04255a7febe9712ffc204 |
| institution | Directory Open Access Journal |
| issn | 2090-911X |
| language | English |
| last_indexed | 2024-04-24T07:14:17Z |
| publishDate | 2024-04-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Heart Journal |
| spelling | doaj.art-90dae9d0f5d04255a7febe9712ffc2042024-04-21T11:22:46ZengSpringerOpenThe Egyptian Heart Journal2090-911X2024-04-0176111210.1186/s43044-024-00478-2Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patientsPramitha Esha Nirmala Dewi0Montarat Thavorncharoensap1Bangunawati Rahajeng2Doctor of Philosophy Program in Social, Economic, and Administrative Pharmacy, Department of Pharmacy, Faculty of Pharmacy, Mahidol UniversitySocial and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Faculty of Pharmacy, Mahidol UniversityDepartment of Pharmacy Profession, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah YogyakartaAbstract 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.https://doi.org/10.1186/s43044-024-00478-2Acute coronary syndromeCost–utility analysisHigh-intensity stainCost per quality-adjusted life year |
| spellingShingle | Pramitha Esha Nirmala Dewi Montarat Thavorncharoensap Bangunawati Rahajeng Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients The Egyptian Heart Journal Acute coronary syndrome Cost–utility analysis High-intensity stain Cost per quality-adjusted life year |
| title | Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients |
| title_full | Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients |
| title_fullStr | Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients |
| title_full_unstemmed | Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients |
| title_short | Cost–utility analysis of using high-intensity statin among post-hospitalized acute coronary syndrome patients |
| title_sort | cost utility analysis of using high intensity statin among post hospitalized acute coronary syndrome patients |
| topic | Acute coronary syndrome Cost–utility analysis High-intensity stain Cost per quality-adjusted life year |
| url | https://doi.org/10.1186/s43044-024-00478-2 |
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