posted 11/01/02
Giving atorvastatin every other day was as effective in
lowering low-density lipoprotein cholesterol (LDL-C) levels as giving it daily,
saving more than $269/patient.
That, according to a pilot study reported in the
October issue of the American Heart Journal. The mean dose was
higher but the average daily dose was lower, resulting in cost savings.
"The average monthly cost for each 1% reduction
in LDL-C resulted in annualized cost savings of $269 per patient for the
alternate-day group," write Mazen S. Matalka, PharmD, from the Veterans
Administration Central California Health Care System in Fresno, and colleagues.
In the Alternate Day Versus Daily Dosing of
Atorvastatin Study (ADDAS), a double-blind, placebo-controlled pilot study, 35
eligible patients who met National Cholesterol Education Program (NCEP) Adult
Treatment Panel II (ATP II) guidelines for drug therapy were randomized to
treatment with 10 mg of atorvastatin as an initial dose daily or every other
day. At six and 12 weeks, the dose was doubled in patients who had not met the
LDL-C goal.
At six weeks, LDL-C levels decreased by 27% in
the alternate-day group and by 38% in the daily group. At 12 weeks, LDL-C levels
decreased by 35% in the alternate-day and by 38% in the daily group (P=.49).
More patients achieved their LDL-C goal in the daily group than in the
alternate-day group (75% vs. 43%). Mean dose was 18 mg (9 mg/d) in the
alternate-day group (n=14) and 12 mg/d in the daily group (n=12) at the end of
the 12-week study (P=.001).
"Although higher doses of atorvastatin were used on alternate days, these results suggest that the alternate-day administration of atorvastatin can produce a reduction in LDL-C comparable to that of daily administration in patients with hypercholesterolemia, and yet provide some cost savings," the authors write.
Source: Diabetes In Control Dot Com: Am Heart J. 2002;144:674-677.
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