ROUTINE ARTICLE The Cost-Effectiveness of Fluvastatin in Hungary Following Successful Percutaneous Coronary Intervention Paul A. Scuffham & Jo ´ zsef Ko ´ sa Published online: 21 June 2006 # Springer Science + Business Media, LLC 2006 Abstract Background The Lescol Intervention Prevention Study (LIPS) showed substantial gains in health out- comes from statins following PCI. That study was a randomized double-blind placebo-controlled trial un- dertaken in 77 centres, predominantly in Europe, of patients with moderate hypercholesterolemia who had undergone their first PCI. The evidence on cost- effectiveness has been established for the UK, USA and the Netherlands, but due to different health system cost structures, the results may not be applica- ble to other European countries. The aim of this study was to estimate the cost-effectiveness of fluvastatin used following first PCI in Hungary. Materials and methods A deterministic Markov model was used to estimate the incremental costs per quality- adjusted life year gained, with cost data drawn from the Hungarian National Health Insurance Fund. Ef- fectiveness data on fluvastatin was derived directly from LIPS and utility weights from previous studies on heart disease. Sensitivity analyses were conducted around key parameters and analyses were conducted for subgroups identified in LIPS. Results Treatment with fluvastatin cost an additional "1,704 and resulted in an additional 0.107 QALYs per patient discounted over 10-years compared with con- trols. The incremental cost per quality-adjusted life year gained was "15,910. The key determinants of cost- effectiveness were the effectiveness of fluvastatin, utility weights, cost of fluvastatin, and the time horizon evaluated. Fluvastatin was substantially more cost- effective in patients with diabetes, renal disease, multi-vessel disease or LDL-cholesterol >3.4 mmol/l. Conclusions Fluvastatin is an economically efficient pharmaceutical for reducing heart disease in Hungary and other European countries in patients following PCI. Key words ischemic heart disease . markov model . statins . QALYs . economic evaluation Introduction Atherosclerotic plaque causing narrowing of coronary arteries (stenosis) is the most common cause of coronary artery disease (CAD). Of all OECD countries in 2001, age-standardized mortality due to ischemic heart disease (IHD) in Hungary was second to the Slovak Republic, with 212.9 deaths per 100,000 [1]. This is nearly five times greater than France and 1.6 times greater than the UK [1]. In addition, CAD results in significant morbidity and loss of quality of life. Approximately 700 thousand people in Hungary have IHD, and 28.6% of males and 23.9% of females aged 65 and over have IHD [2]. Percutaneous coronary intervention (PCI) has be- come a routine and effective procedure to remove occlusions from coronary arteries. Over the last decade Cardiovasc Drugs Ther DOI 10.1007/s10557-006-8877-3 P.A. Scuffham (*) Griffith University, Brisbane, Australia email: P.Scuffham@griffith.edu.au P.A. Scuffham York Health Economics Consortium Ltd, University of York, York, UK J. Ko ´ sa Novartis Hungary Ltd., Budapest, Hungary