Analytical approach:
The long-term cost-effectiveness of both strategies was assessed using a Markov model, in which patients were treated for five years and were followed up to a maximum age of 100 years. The long-term survival was calculated by estimating the risk of death using Weibull regressions. The authors did not state a study perspective.
Effectiveness data:
The effectiveness data were obtained from the Incremental Decrease in Endpoints Through Aggressive Lipid Lowering (IDEAL) trial. This was a prospective, randomised, open-labelled, blinded trial of 8,888 patients under 80 years old who had experienced an AMI. These patients were followed for an average of 4.8 years.
Monetary benefit and utility valuations:
The utility weights were obtained from published literature, where the data were evaluated using the EuroQol-5D questionnaire.
Measure of benefit:
The measures of benefit were life-years gained and quality-adjusted life-years (QALYs). Future health benefits were discounted at an annual rate of 3%.
Cost data:
The cost categories were the cost of medication, hospitalisation, the costs for various events and procedures, and productivity losses due to absence from work. The costs were based on resource consumptions recorded in the trial multiplied by the recent unit costs from each country and these were reported in Euros (EUR). The price year was 2005. Future costs were discounted at annual rate of 3%.
Analysis of uncertainty:
Parameter uncertainty was investigated through probabilistic sensitivity analysis using second order Monte Carlo simulations. The distributions were extrapolated using non-parametric bootstrapping. These results were reported in the form of cost-effectiveness acceptability curves based on the net-benefit data.