An economic evaluation of rosuvastatin treatment in systolic heart failure: evidence from the CORONA trial

To estimate the cost-effectiveness of 10 mg rosuvastatin daily for older patients with systolic heart failure in the Controlled Rosuvastatin Multinational Study in Heart Failure (CORONA) trial. This within trial analysis of CORONA used major cardiovascular (CV) events as the outcome measure. Resource use was valued and the costs of hospitalizations, procedures, and statin use compared. Cost-effectiveness was estimated as cost per major CV event avoided. There were significantly fewer major CV events in the rosuvastatin group compared with the placebo group (1.04 vs. 1.20 per patient; difference 0.164; 95% CI: 0.075-0.254, P < 0.001). The average cost of CV hospitalizations and procedures was significantly lower for those receiving rosuvastatin (1531 pound vs. 1769; pound difference 238; pound 95% CI: 73-403 pound, P = 0.005); the additional cost of the statin resulted in significantly higher total costs for the rosuvastatin group (1769 pound vs. 2072; pound difference 303; pound 95% CI: 138-468 pound, P < 0.001). Overall, rosuvastatin was found to cost 1840 pound (95% CI: 562-6028) pound per major CV event avoided. This economic analysis showed that a significant reduction in major CV events with rosuvastatin led to significantly reduced costs of CV hospitalizations and procedures. The reduction in associated costs for major CV events was found to offset partially (by 44%) the cost of rosuvastatin treatment in patients with systolic heart failure.