Statin Utilization and Its Cost Effectiveness in Patient with Type 2 Diabetes
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Abstract
This study focused on statin therapy for primary prevention of the cardiovascular events in patients with type 2 diabetes in Thai-healthcare context. Three main objectives were studied and their results were summarized separately as follows.
A cost effectiveness analysis of statin therapy for primary prevention of cardiovascular events in patients with type 2 diabetes who were 50 to 65 ye.ar of age with LDL-C 115 to 149 mg/dl, was performed. The analyses revealed that this intervention is worthwhile with an incremental cost-effectiveness ratio of 20,608 Baht per QALY.
Academic detailing by a pharmacist was tested whether it can increase physicians’ prescribing rates on statin therapy and lipid profile monitoring in patients with type 2 diabetes. The effect of academic detailing was examined in three district hospitals. The numbers of patients who had lipid profile monitoring increased from 14-37% to 16-47%, but statin therapy for patients who did not have LDL-C goal achieved according to the Third Report of the National Cholesterol Education Program (NCEP III) was still low (0-37%).
Statin availability in hospital formulary before and after the National List of Essential Drug 2004 was released, was evaluated. Statin availability and lipid profile monitoring was available in all hospitals with 300 beds or more and about 71-84% in the hospitals with 60 beds or less, or those with 90 to 120 beds. For the hospitals indicating that they did not have statins in their hospital formularies, they reported that the process of including statins is underway and it should be done within 6 months. Thereby, at the present time statins are likely to be available in all levels of hospitals in Thailand.
In conclusion, although statin therapy for primary prevention of cardiovascular events in patients with type 2 diabetes is cost-effective in Thai-healthcare context, but statins prescribing for this population was still low. Academic detailing can not promote rates of statin prescribing and lipid profile monitoring.
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