Skip to main content
SpringerLink
Log in

Cost-Effectiveness Study of a Lipid-Lowering Therapy in Hyperlipoproteinaemia Type IIb and Type IV (Frederickson)

  • Original Research Article
  • Published:
PharmacoEconomics Aims and scope Submit manuscript

Summary

We performed a cost-effectiveness simulation of acipimox, bezafibrate, fenofibrate and gem-fibrozil in patients with hyperlipoproteinaemia type IIb and IV [Frederickson]. A distinction was made between patients with HLP type IIb and IV and HLP associated with diabetes mellitus type II (NIDDM). Direct costs were assessed as those incurred by social security for the treatment, and indirect costs were not taken into account. In appropriate dosages, all 4 substances can be considered equally efficacious in lowering lipid levels, although gallstones occur 3 times more frequently in patients treated with fibrates than in those treated with acipimox. Acquisition costs of the 4 drugs under consideration are comparable. Thus, when hospitalisation costs for treatment of gallstones are taken into account, therapy with acipimox is more cost effective than fibrate therapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Assmann G, Schulte H. Prospective cardiovascular Miinster study: prevalence and prognostic significance of hyperlipidemia in men with systemic hypertension. American Journal of Cardiology 59: 9G–17G, 1987

    Article  PubMed  CAS  Google Scholar 

  • Assmann G, Schulte H. The prospective cardiovascular Miinster (PROCAM) study: prevalence of hyperlipidemia in persons with hypertension and/or diabetes mellitus and the relationship to coronary heart disease. American Heart Journal 116: 1713–1724, 1988

    Article  PubMed  CAS  Google Scholar 

  • Assmann G, Schulte H. Diabetes mellitus and hypertension in the elderly: concomitant hyperlipidaemia and coronary heart risk. American Journal of Cardiology 63: 33H–37H, 1989

    Article  PubMed  CAS  Google Scholar 

  • Beck RJ, Pauker SG. The Markov process in medical prognosis. Medical Decision Making 3: 419–458, 1983

    Article  PubMed  CAS  Google Scholar 

  • Crane VS. Economic aspects of clinical decision making: applications of clinical decision analysis. American Journal of Hospital Pharmacy 45: 548–553, 1988

    PubMed  CAS  Google Scholar 

  • Doubilet P, Begg CB, Weinstein MC. Probabilistic sensitivity analysis using Monte Carlo simulation. Medical Decision Making 5: 157–177, 1985

    Article  PubMed  CAS  Google Scholar 

  • Ericsson S, Eriksson M, Angelin B. Biliary lipids in familial combined hyperlipidemia: effects of acipimox therapy, European Journal of Clinical Investigation 20: 261–265, 1990

    Article  PubMed  CAS  Google Scholar 

  • Frick MH, Elo O, Haapa K, Heinonen OP, Heinsalm P, et al. Helsinki heart study: primary prevention trial with gemfibrozil in middle-aged men with dyslipidemia. New England Journal of Medicine 317: 1237–1245, 1987

    Article  PubMed  CAS  Google Scholar 

  • Grundy SM, Vega GL. Fibric acids: effects on lipids and lipoprotein metabolism. American Journal of Medicine 83: 9–20, 1987

    Article  PubMed  CAS  Google Scholar 

  • Krüger KJ, Luley C, Schumacher M, Rieder H, Kaplan E, et al. Improvement of blood glucose and uric acid in 1434 patients under treatment with Acipimox for 2 years. Proceedings 56th European Atherosclerosis Congress, Cagliari 1990, p. 214, (in press)

    Google Scholar 

  • Lavezzari M, Milanesi G, Oggioni E, Pamparana F. Results of a phase IV study carried out with Acipimox in Type II diabetic patients with concomitant hyperlipoproteinaemia. Journal of International Medical Research 17: 373–380, 1989

    PubMed  CAS  Google Scholar 

  • LaRosa JC, Chambless L, Criqui M, Frantz I, Glueck C. Patterns of dyslipoproteinemias in selected North American populations. Lipid Research Clinics Program Prevalence Study. Circulation 73 (Suppl. I): I-1–1-28, 1986

    Google Scholar 

  • Leiss O, von Bergmann K, Gnasso A. Effect of gemfibrozil on biliary lipid metabolism in normolipemic subjects. Metabolism 34: 74–82, 1985

    Article  PubMed  CAS  Google Scholar 

  • Leiss O, Meyer-Krahmer K, von Bergmann K. Biliary lipid secretion in patients with heterozygous familial hypercholesterolemia and combined hyperlipidemia. Influence of bezafibrate and fenofibrate. Journal of Lipid Research 27: 213–223, 1986

    Google Scholar 

  • Lipid Research Clinics Coronary Primary Prevention Trial Results: I. Reduction in incidence of coronary heart disease. Journal of the American Medical Association 251: 351-364, 1984a

  • Lipid Research Clinics Coronary Primary Prevention Trial Results: II. The relationship of reduction in incidence of coronary heart disease to cholesterol lowering. Journal of the American Medical Association 251: 365-374, 1984b

  • Luce BR, Elixhauser A. Standards for socioeconomic evaluation of health care products and services: decision analysis, pp. 117–123, Springer Verlag, 1990

    Google Scholar 

  • Luley C, Kriiger KJ, Schumacher M, Kaplan E, Kloer HV. Efficacy of Acipimox in 6255 hyperlipidemic patients being treated for 2 years. Proceedings 56th European Atherosclerosis Congress, Cagliari, p. 218, 1990

    Google Scholar 

  • Manninen V, Elo MO, Frick M, Haapa K, Heinonen OP. Lipid alterations and decline in the incidence of coronary heart disease in the Helsinki heart study. Journal of the American Medical Association 260: 641–651, 1988

    Article  PubMed  CAS  Google Scholar 

  • Manninen V, Huttunen J, Heinonen OP, Tenkanen L, Frick M. Relation between baseline lipid and lipoprotein values and the incidence of coronary heart disease in the Helsinki heart study. American Journal of Cardiology 63: 42H–47H, 1989

    Article  PubMed  CAS  Google Scholar 

  • Martin M, Hulley S, Browner W, Kuller L, Wentworth D. Serum cholesterol, blood pressure and mortality: implications from a cohort of 361 662 men. Lancet 8513: 933–936, 1986

    Article  Google Scholar 

  • Muggeo M, Lavezzari M, Montoro C, Sachetti G. Long-term mul-ticenter trial with Acipimox in diabetic patients with hyperlipoproteinemia in atherosclerosis and cardiovascular diseases. Proceedings of the 6th International Meeting on Atherosclerosis and Cardiovascular Diseases, Bologna, Italy, October 27–29, 1986, MTP Press Ltd, Lancaster, 1987

    Google Scholar 

  • Palmer RH. Prevalence of gallstones in hyperlipidemia and incidence during treatment with Clofibrate and/or Cholestyramine. Transactions of the Association of American Physicians 91, 424–432, 1978

    PubMed  CAS  Google Scholar 

  • Palmer RH. Effects of fenofibrate on bile lipid composition. Arteriosclerosis 5: 631–638, 1985

    Article  PubMed  CAS  Google Scholar 

  • Pomrehn P, Duncan B, Weissfeld L, Wallace R, Barnes R. The association of dyslipoproteinemia with symptoms and signs of peripheral arterial disease. Lipid Research Clinics Program Prevalence Study. Circulation 73 (Suppl. I): 1100–1107, 1986

    Google Scholar 

  • Pottins I, Schwartzkopff W. Relationship between cholelithiasis, hyperlipoproteinemia and their therapy with Bezafibrate retard and Gemfibrozil. Die Medizinische Welt 38: 1662–1667, 1987

    Google Scholar 

  • Rothschild JG, Holbrook RF, Reinhold RB. Gallstone lithotripsy vs. cholecystectomy: a preliminary cost-benefit analysis. Archives of Surgery 125: 710–714, 1990

    Article  PubMed  CAS  Google Scholar 

  • Rubenstein C, Romhilt D, Segal P, Heiss G, Chambless L. Dyslipoproteinemias and manifestations of coronary heart disease. Lipid Research Clinics Program Prevalence Study. Circulation 73 (Suppl. I): 1-91–1-99, 1986

    Google Scholar 

  • Schettler G. Innere Medizin, 6th ed., p. 498, Thieme Verlag, Stuttgart, 1986

    Google Scholar 

  • Schweizerische Sterbetafel 1978/1983, Bundesamt f. Statistik, Bern 1988 pp. 59 & 85, 1988

  • Schweizerische Krankenhauswesen 1987 in Zahlen, Veska-Statis-tik-Zentrale, 1987 Schweizer Spital. 52. Jahrgang, Heft 11, Tab. 1.03.7, 1988

  • Sempos C, Fulwood R, Haines C, Carroll M, Anda R. The prevalence of high blood cholesterol levels among adults in the United States. Journal of the American Medical Association 262: 45–52, 1989

    Article  PubMed  CAS  Google Scholar 

  • Statistisches Jahrbuch der Schweiz 1989, Verlag NZZ, Zurich, 1989

  • Tonutti L, Taboga C, Noacco C. Comparison of the efficacy of pantethine, acipimox and bezafibrate on plasma lipids and index of cardiovascular risk in diabetics with dyslipidemia. Minerva Medica 82: 657–663, 1991

    PubMed  CAS  Google Scholar 

  • VESKA Medizinische Statistik. Gesamtstatistik 1988. Diagnosen end Operationen. Vereinigung Schweizerischer Krankenhauser (VESKA), Aarau, 1989

    Google Scholar 

  • von Sonnenberg A, Leuschner U, Leuschner M. Erwartungskos-ten bei den konservativen und chirurgischen Behandlungen der unkomplizierten Cholozystolithiasis, Z. Gastroenterologie 20: 66–77, 1982

    CAS  Google Scholar 

  • Wahl P, Hasslacher C, Lang P, Vollmar J. Der lipidsenkende Ef-fekt von Bezafibrat bei Patienten mit Diabetes mellitus end Hyperlipidamie. Deutsche Medizinische Wochenschrift 103: 1233–1237, 1978

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Institute for Medical Informatics and Biostatistics, Bachtelenweg 3, CH-4125, Riehen, Switzerland

    Rito Bergemann, Arno Brandt & Walter Siegrist

Authors
  1. Rito Bergemann
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Arno Brandt
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Walter Siegrist
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bergemann, R., Brandt, A. & Siegrist, W. Cost-Effectiveness Study of a Lipid-Lowering Therapy in Hyperlipoproteinaemia Type IIb and Type IV (Frederickson). Pharmacoeconomics 3, 131–139 (1993). https://doi.org/10.2165/00019053-199303020-00006

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00019053-199303020-00006

Keywords

Search

Navigation