The effect of statin treatment on survival and on the use of healthcare resources among patients with acute myocardial infarction

  • Lien Nguyen Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL)
  • Unto Häkkinen Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL)
  • Henna Jurvanen Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL)
Keywords: statin use, acute myocardial infarction AMI, cost-effectiveness, mortality, healthcare costs, PERFECT

Abstract

The aim of this study was to investigate the cost-effectiveness of statin use by newly hospitalised patients with acute myocardial infarction (AMI) in Finland. The data were from the PERFECT database of patients hospitalised for AMI and discharged in 1998–2012 in Finland. Selected patients had first-time AMI and had not used statins earlier (N=60 404). We generated a matched data set from statin non-users for statin users based on propensity matching analysis (N=28 412), which was also used. Statin use was defined as statins purchased within the first week after hospital discharge. Healthcare costs included costs of inpatient and outpatient hospital care, costs of nursing homes and costs of prescribed medicines (at 2011 prices). The follow-up time was one year. Logit and generalised linear models were used. We measured the effects of statin use as life years (LYs) gained and computed costs per LY gained. Both data were analysed for the entire period and for subperiods 1998–2001, 2002–2007 and 2008–2011, without discount rates and with a 3% discount rate. An average patient would gain 0.26–0.51 more years. The estimated costs per LY gained ranged between EUR 800 and 15 000. They were highest (EUR 12 000–15 000) in 1998–2001 by the matched data, but were actually savings in 2008–2011. The estimated costs indicate that statin use in treating AMI was very cost-effective. However, our rather long study period may suggest that the cost estimates per LY gained could be overestimated, as the life expectancy of AMI patients is likely shorter than that of the general population.


Published: Online April 2018.

Author Biographies

Lien Nguyen, Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL)
Lien Nguyen is a senior researcher at the Centre for Health and Social Economics of the National Institute for Health and Welfare (THL) in Finland. She received a doctor’s degree in social sciences from the University of Helsinki in Helsinki, Finland. Her major subject was economics. Since July 2015, she has been involved in the EXCELC project that explores comparative effectiveness and efficiency in long-term care in Austria, England and Finland. She is interested in health economics research, such as health care utilization, health care performance, equity/equality, public health, and health behavior and policy.
Unto Häkkinen, Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL)
Unto Häkkinen (PhD) is a Research Professor at CHESS. During 2006-2007, he undertook consultancy work for the OECD in relation to proposals for future OECD work on measuring efficiency in the health care sector. He has been a Finnish co-ordinator in many international comparisons as well being the co-ordinator of the PERFECT and EuroHOPE projects. His academic and applied research has mainly focused on health economics covering topics such as cost, financing and outcomes of health services, equity in health and health care, demand and utilisation of health care, payment systems in health care, health care reforms, allocation of health care resources, regional variation of health care, hospital productivity, care of the elderly and register-based analyses of costs and outcomes in health care.
Henna Jurvanen, Centre for Health and Social Economics (CHESS), National Institute for Health and Welfare (THL)
Henna Jurvanen (PhD) is a mathematician and is currently working as a researcher at CHESS at THL where her main responsibilities concern data management of register data. Her PhD research concentrated on pure mathematics. She worked several years as mathematician in an insurance company. At THL she has worked in international and national projects. Her current research is focused on costs and outcomes of health services and the performance of health care systems.
Published
2018-04-17