Analytical approach:
The Korean Individual-Microsimulation Model for Cardiovascular Health Interventions was created. This was an epidemiologic and economic Markov model with a 40-year time horizon. The authors stated that the perspective of the health care system was adopted.
Effectiveness data:
The clinical data came from a selection of relevant studies. The baseline patient data were from a sample of 372 people, with a mean age of 59.3 years, who completed the 2005 Korean National Health and Nutrition Examination Survey (KNHNES). The efficacy of statin therapy, which was the key input to the model, was derived from a published meta-analysis of 18 head-to-head randomised controlled trials. The transition probabilities were from a study of more than 11,000 Chinese people living in either the USA or the People’s Republic of China. Published sources and official statistics were used for other inputs.
Monetary benefit and utility valuations:
The utility values were derived from an analysis of the KNHNES data, which was supplemented with information from other published studies.
Measure of benefit:
Life-years (LYs) and quality-adjusted life-years (QALYs) were the summary benefit measures. A 5% annual discount rate was applied.
Cost data:
The economic analysis included the costs of drugs and the costs of cardiovascular disease (fatal and non-fatal events). The drug costs were from the pharmaceutical price lists in Korea and they included the costs of physician visits and monitoring. Cardiovascular disease costs, with and without insurance coverage, were from the Health Insurance Review and Assessment Service. The price year was 2008, all costs were in Korean won (KRW), and they were discounted at an annual rate of 5%.
Analysis of uncertainty:
One-way sensitivity analyses were carried out on the model inputs, using published confidence intervals for some inputs and arbitrary ranges (± 25%) of values for others. The key model inputs were varied in a multivariate analysis, with 2,000 iterations, in a Monte Carlo simulation.