A193 Abstracts CV3 COST-EFFECTIVENESSS OF INTENSIVE STATIN THERAPY COMPARED TO MODERATE STATIN THERAPY IN PATIENTS WITH ACUTE CORONARY SYNDROME: ANALYSIS FROM CANADA, GERMANY AND THE UK Drummond MF 1 , Schwartz JS 2 , Koren M 3 , Cannon C 4 , Davie A 5 , Shui A 4 , Murphy S 4 , Graff J 6 1 University of York,York, Heslington, UK, 2 University of Pennsylvania, Merion Stn, PA, USA, 3 Memorial Hospital, Jacksonville Heart Center, Jacksonville Center for Clinical Research, Jacksonville, FL, USA, 4 Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA, 5 I3 Innovus, Uxbridge, Middlesex, UK, 6 Pfizer, Inc, New York, NY, USA OBJECTIVES: The PROVE IT-TIMI 22 trial demonstrated clin- ical benefit of intensive lipid lowering (atorvastatin 80 mg) vs. moderate lipid lowering (pravastatin 40 mg) in patients with acute coronary syndrome (ACS). Prior US analysis found lower net costs for intensive Rx. The objective of this analysis was to evaluate cost-effectiveness of intensive vs. moderate statin therapy in ACS patients in the UK, Germany and Canada where generic pravastatin is available and hospitalization costs lower than in the US. METHODS: Hospitalization and length of treat- ment were obtained from PROVE-IT case report forms. Hospi- talizations were classified by relevant DRG system and multiplied by associated hospitalization costs in the UK, Germany and Canada. Drug costs were obtained from each country’s public or tariff prices. RESULTS: Compared with mod- erate pravastatin therapy, intensive atorvastatin therapy was associated with fewer hospitalizations (1301 vs. 1444; 0.62/pt vs. 0.70/pt). Total costs (hospital + drug) per patient of intensive vs. moderate therapy were ≤3184 vs. ≤3236 (UK), €5242 vs. €5515 (Germany) and CA$7386 vs. CA$8087 (Canada), with savings per patient of ≤56, €284 and CA$701 respectively over the 2-year study period. Thus, increased drug acquisition costs were more than offset by reduced hospitalization costs in all three countries. Sensitivity analysis on treatment pattern varia- tions, events and costs will be conducted. If the PROVE-IT results are generalizable to all ACS patients, the savings from intensive vs. moderate statin therapy per two years of treatment would be £5.6 million, €28.4 million and CA$70.1 million for every 100,000 ACS patients in the UK, Germany and Canada, respectively. CONCLUSIONS: As observed in PROVE-IT, inten- sive atorvastatin therapy reduced clinical events and costs com- pared to moderate pravastatin therapy among ACS patients in the UK, Germany and Canada and thus is clinically beneficial at a lower overall cost among PROVE-IT ACS patients, allowing allocation of resources to other therapy options. CV4 ASSESSING COST-EFFECTIVENESS BEFORE MARKETING: A CASE-STUDY OF RIMONABANT FOR REDUCTION OF CARDIOMETABOLIC RISK IN PATIENTS WITH DYSLIPIDEMIA IN THE UK Car o JJ 1 , Getsios D 2 , Proskorovsky I 3 , Nicholls C 4 , McEwan P 5 1 Caro Research Institute, Concord, MA, USA, 2 Caro Research Institute, Halifax, NS, Canada, 3 Caro Research Institute, Dorval, QC, Canada, 4 Sanofi-Aventis, Guildford, Surrey, UK, 5 Cardiff Research Consortium, Cardiff, UK OBJECTIVE: Often cost-effectiveness analyses must be under- taken before a price for the product has been set. This study eval- uated the expected cost-effectiveness of rimonabant, the first selective CB-1 receptor blocker, for treatment of patients with dyslipidemia in the UK under various price assumptions. METHODS: A Markov model (SHAPE) was developed using data from clinical trials, published risk equations and UK patient profiles from the Health Outcomes Data Repository Database (HODaR) registry. Patients transition from At Risk or Diabetes to CVD based on UKPDS 68 or Framingham Heart study equations, or to death based on UK life-tables, and to diabetes (San Antonio Heart study) and subsequent CVD events (Saskatchewan equations). UK costs for acute resource use upon transition as well as longer term routine management are accrued in 2005 GBP. Age-dependent utilities are calculated and tariffs for all events and states are applied. Rimonabant effects on car- diometabolic risk factors were taken from the RIO Lipids trial. Ten year and lifetime horizons were examined; all outcomes were discounted at 3.5%/yr. Extensive probabilistic sensitivity analy- ses were carried out. RESULTS: Over ten years, >13% of patients are expected to suffer a cardiovascular event with a loss of more than 1045 QALYs and a cost above £600,000 per 1000 patients. Adding rimonabant to diet & exercise for only one year is estimated to gain >100 QALYs over a lifetime. Preliminary cost-effectiveness ratios remained acceptable (less then ≤20,000/QALY) under a wide range of assumptions and when testing hypothetical prices as high as ≤8 per day. CONCLU- SIONS: Based on the reductions in total to HDL cholesterol ratio, weight and other risk factors seen in RIO Lipids trial, rimonabant should substantially reduce cardiovascular risk in obese or overweight patients with dyslipidemia and result in an acceptable cost-effectiveness ratio. METHODS & CONCEPTS I MC1 GROWTH, CHARACTERISTICS,AND QUALITY OF THE COST- UTILITY LITERATURE THROUGH 2003 Palmer JA 1 , Cohen JT 2 , Cochran GL 3 , Eldar-Lissai A 4 , Greenberg D 5 , Lavelle TA 6 ,Wang ST 7 , Neumann PJ 2 1 Tufts-New England Medical Center, Boston, MA, USA, 2 Tufts University School of Medicine, Boston, MA, USA, 3 University of Nebraska Medical Center, Omaha, NE, USA, 4 University of Rochester, Rochester, NY, USA, 5 Ben-Gurion University of the Negev, Beer- Sheva, Israel, 6 Harvard University, Cambridge, MA, USA, 7 Harvard School of Public Health, Boston, MA, USA OBJECTIVES: 1) To quantify and characterize the cost-utility analyses (CUAs) published in the scientific literature through 2003; and 2) to examine methodological practices used in these CUAs. This paper builds upon our previous analyses that eval- uated CUAs from 1976 through 2001. METHODS: We system- atically searched Medline and the Health Economic Evaluations Database (HEED) for original CUAs written in English and pub- lished during 2002–2003 to update a comprehensive registry of CUAs (www.tufts-nemc.org/cearegistry). Two trained readers independently extracted data on the characteristics and method- ology of each study. We compared recently published (2002–2003) with previously published (1976–2001) data. RESULTS: Our previous search identified 533 original CUAs published during 1976–2001; a finding of 262 studies published during 2002–2003 increased the sample by almost 50%. In the 1976–2001 and 2002–2003 data, most studies were based in the US (61%, 53%) and written by academics (90%, 92%). Studies examined treatment (63%, 62%) more than primary (14%, 16%) and secondary (22%, 21%) prevention. The most frequent condition studied was cardiovascular disease (21%, 18%). Per- centage of funding by the pharmaceutical and device industry did not change substantially (19%, 23%). Studies improved with time across the two datasets: disclosing funding source (65% vs. 71%), stating year of currency (76% vs. 82%), reporting incre- mental ratios (59% vs. 79%), and using probabilistic sensitivity analyses (9% vs. 28%). CONCLUSIONS: The publication of