Are Intensive Lipid-lowering Regimens an Optimal Economic Strategy in Patients with ACS? An Acute and Chronic Perspective

Roberta Ara; Rachid Rafia; Sue E Ward; Anthony S Wierzbicki; Tim M Reynolds; Angie Rees; Abdullah Pandor


Expert Rev Pharmacoeconomics Outcomes Res. 2009;9(5):423-433. 

In This Article

Method of Review

Search Strategy

Studies were identified through searches of MEDLINE, Excerpta Medica Database [EMBASE], Cochrane Library, NHS Economic Evaluation Database [NHSEED], NHS Centre for Reviews and Dissemination [CRD] Database of Abstracts of Reviews of Effects [DARE], NHS CRD Health Technology Assessment Database [HTA], Cumulative Index to Nursing and Allied Health Literature [CINAHL], Office of Health Economics [OHE] Health Economic Evaluations Database [HEED] and Web of Science, from inception to February 2009. Searches were supplemented by hand-searching relevant journals, citation searching of included studies and consulting experts in the field.

Study Selection

Two reviewers independently screened the searches for potentially relevant studies. The full manuscripts of all potentially relevant studies were retrieved and each study was assessed independently by two reviewers for inclusion using predetermined eligibility criteria. Any differences in selection were resolved through discussion to achieve consensus. Studies were included if they were a cost–effectiveness or cost–utility analysis of an intensive lipid-lowering strategy versus a standard-dose statin in patients with ACS, and reported results in terms of cost per life-years or cost per quality-adjusted life-years (QALYs). Studies were excluded if they were published in abstract form only, restricted to cohorts with homozygous familial hypercholesterolemia, did not present results for individual statins identified by both brand and dose, or presented results for treatment titrations.

The next section provides an overview of the studies included in this review followed by a comparison of the data used and the methodological approaches taken. This is followed by a comparison of the results reported in the studies.


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