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Cost-outcome benefits of fibrate therapy in type 2 diabetes

Beta Cell Diabetes Centre, Chelsea & Westminster Hospital, London SW10, UK, m.feher{at}chelwest.nhs.uk

Clare E Langley-Hawthorne

Health Economics Group, Ethical Strategies Ltd, Surrey, UK

Christopher D Byrne

South Academic Block, Southampton General Hospital, UK

To date there have been few studies focusing on economic assessments of fibrate therapy in the management of coronary heart disease (CHD), particularly in patients with type 2 diabetes. A cost-effectiveness model for an economic analysis was established by an assessment of `cost per CHD event avoided' for fibrate therapy. This model was derived from: i) data on CHD events in patients with and without diabetes from randomised controlled trials of lipid-lowering agents, ii) comparisons of fibrate and HMG CoA reductase inhibitor (statin) treatment compared to no treatment and iii) current UK-based drug and clinical event costs. Treatment benefits over a five-year period were calculated, and the sensitivity of the model to the individual variables tested. Fibrate therapy was substantially more cost-effective than statin therapy in patients with diabetes. Economic costings for fenofibrate, as the index fibrate commonly used in the UK, confirmed an annual cost of £2,642— £3,700 per CHD event avoided over a five-year assessment period. Cost-effectiveness ratios derived in the economic model demonstrated that fibrate therapy was equally effective as statin therapy, but at a 54% reduction in annual cost. Current and future CHD treatment guidelines should incorporate pharmacoeconomic data for fibrate as well as statin therapy.

Key Words: diabetes • fibrate • cost-effectiveness • guidelines.

The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 2, 124-130 (2003)
DOI: 10.1177/14746514030030020801


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