The European Journal of Health Economics

, Volume 10, Issue 3, pp 255–265

Cost-effectiveness of intensive atorvastatin therapy in secondary cardiovascular prevention in the United Kingdom, Spain, and Germany, based on the Treating to New Targets study

  • Douglas C. A. Taylor
  • Ankur Pandya
  • David Thompson
  • Paula Chu
  • Jennifer Graff
  • James Shepherd
  • Nanette Wenger
  • Heiner Greten
  • Rafael Carmena
  • Michael Drummond
  • Milton C. Weinstein
Original Paper


The Treating to New Targets (TNT) clinical trial found that intensive 80 mg atorvastatin (A80) treatment reduced cardiovascular events by 22% when compared to 10 mg atorvastatin (A10) treatment. We evaluated the cost-effectiveness of intensive A80 vs A10 treatment in the United Kingdom (UK), Spain, and Germany. A lifetime Markov model was developed to predict cardiovascular disease-related events, costs, survival, and quality-adjusted life-years (QALYs). Treatment-specific event probabilities were estimated from the TNT clinical trial. Post-event survival, health-related quality of life, and country-specific medical-care costs were estimated using published sources. Intensive treatment with A80 increased both the per-patient QALYs and corresponding costs of care, when compared to the A10 treatment, in all three countries. The incremental cost per QALY gained was € 9,500, € 21,000, and € 15,000 in the UK, Spain, and Germany, respectively. Intensive A80 treatment is estimated to be cost-effective when compared to A10 treatment in secondary cardiovascular prevention.


Cardiovascular disease Cholesterol lowering Cost-effectiveness Decision analysis Markov model Secondary prevention Statin therapy 

JEL Classification



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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Douglas C. A. Taylor
    • 1
  • Ankur Pandya
    • 1
  • David Thompson
    • 1
  • Paula Chu
    • 1
  • Jennifer Graff
    • 2
  • James Shepherd
    • 3
  • Nanette Wenger
    • 4
  • Heiner Greten
    • 5
  • Rafael Carmena
    • 6
  • Michael Drummond
    • 1
    • 7
  • Milton C. Weinstein
    • 1
    • 8
  1. 1.i3 InnovusMedfordUSA
  2. 2.Pfizer Inc.New YorkUSA
  3. 3.University of GlasgowGlasgowUK
  4. 4.Emory University School of MedicineAtlantaUSA
  5. 5.Hanseatisches Herzzentrum HamburgHamburgGermany
  6. 6.Universidad de ValenciaValenciaSpain
  7. 7.University of YorkYorkUK
  8. 8.Department of Health Policy and ManagementHarvard School of Public HealthBostonUSA

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