Avtor/Urednik     Cevc, Matija
Naslov     Farmakoekonomika zdravljenja dislipedemij pri bolnikih z akutnim koronarnim sindromom
Prevedeni naslov     Pharmacoeconomics of dyslipidemia treatment in patients with acute coronary syndrome
Tip     članek
Vir     Slov Kardiol
Vol. in št.     Letnik 3, št. 1
Leto izdaje     2006
Obseg     str. 24-9
Jezik     slo
Abstrakt     Cardiovascular diseases (CVD) are still among the leading causes of mortality and one of the most frequent reason for hospital admission in Slovenia. Hypercholesterolemia is the major risk factor for CVD. Treatment of hyperlipidemia and CVD represents important financial burden. With this analysis we tried to evaluate the cost effectiveness of dyslipidemia treatment when compared to costs of major cardiovascular events (represented by case of acute coronary syndrome - ACS). By lowering the LDL cholesterol with statins for more than 1,5mmol/l in 1000 patients, 50 major cardiovascular events (CVE) would be prevented in primary prevention and 96 major CVE in secondary prevention. Also the number of hospital admission, the length of hospitalisation and the revascularisation rate would be reduced. To achieve the goal of reducing the LDL cholesterol for more than 1,5 mmol/l by the lowest cost statin the cost of treatment for 1000 patients in 5 years would amount to 214.087.150 SIT (893.377 €). By simplifying and taking into account only ACS as major CVE, primary prevention of 50 ACS in 5 years would cost 93.520.489 SIT (390.254,08 €) and secondary prevention of 96 ACS in 5 years would cost 161.073.484 SIT (618.395,81 €). This sum represents only basic costs of ACS treatment that would be doubled by incorporating staff salaries. Hundred and fifty eight subjects younger than 65 years old died in the year 2003 because of ischemic heart diseases. All these deaths could have been prevented if the patients had been adequately treated. With the use of »method of human resources« it can be calculated that these deaths represent additional yearly cost of 3,76 billion SIT (15.69 million €). It seems that the treatment with statins is cost effective in primary as well as in secondary prevention.
Izvleček     Bolezni srca in žilja so v Sloveniji še vedno najpogostejši vzrok smrti in eden najpogostejših razlogov za bolnišnično zdravljenje. Med najpomembnejše dejavnike tveganja za razvoj bolezni srca in žilja pa spada hiperholesterolemija. Zdravljenje dislipidemije in zdravljenje bolezni srca in žilja predstavlja veliko finančno breme. S to analizo smo skušali ocenit, ali so stroški zniževanja serumske ravni LDL holesterola upravičeni, če jih primerjamo s stroški zdravljenja večjih srčno-žilnih dogodkov (na primeru akutnega koronarnega sindroma). Če bi serumsko raven LDL holesterola znižali za več kot 1,5 mmol/L, bi med 1000 bolniki, zdravljenimi s statini, preprečili 50 pomembnih srčno-žilnih dogodkov v primarni preventivi in 96 večjih srčno-žilnih dogodkov v sekundarni preventivi. Sočasno s tem bi zmanjšali tudi potrebo po zdravljenju v bolnišnici in njegovo trajanje, manj bi bilo potreb po revaskularizacijskih posegih. Ob uporabi najcenejšega statina, s katerim dosežemo znižanje serumske ravni LDL holesterola za več kot 1,5 mmol/L, bi zdravljenje 1000 bolnikov v 5 letih stalo 214.087.150 SIT (893.377 €). Ob poenostavitvi, da bi kot pomembni srčno-žilni dogodek šteli le akutni koronarni sindrom, stane zdravljenje s primarno preventivo preprečenih 50 akutnih koronarnih sindromov v 5 letih 93.520.489 SIT (390.254,08 €), v sekundarni preventivi preprečenih 96 akutnih koronarnih sindromov pa 161.073.484 SIT (618.395,81 €). Ta znesek predstavlja le najosnovnejše materialne stroške zdravljenja akutnega koronarnega sindroma, ob upoštevanju stroškov dela, bi se oba zneska podvojila. Leta 2003 je zaradi ishemične bolezni srca pred 65 letom starosti umrlo 158 ljudi. Vse te smrti bi bile lahko ob ustrezni obravnavi bolnikov preprečene. Po "metodi človeškega kapitala" se da izračunati, da te smrti pomenijo samo v enem letu dodaten strošek 3,76 milijarde SIT (15.69 milijonov €). (Izvleček skrajšan na 2000 znakov)
Deskriptorji     HYPERCHOLESTEROLEMIA
DRUG COSTS
CARDIOVASCULAR DISEASES
ANTILIPEMIC AGENTS