Q: Was hoping someone could walk me through this: Statin drugs (3-hydroxy-3-methylglutaryl coenzyme A [HMG-CoA] reductase inhibitors) are drugs used to lower blood cholesterol and reduce the increased cardiovascular disease risk associated with high cholesterol levels. A study in the January 24/31 2001 issue of the Journal of the American Medical Association finds benefit to giving statin drugs to heart attack patients while they are recovering in hospital. Specifically the probability of dying in the first year after release from hospital was found to fall from 10% for those not taking statin while in hospital to 5% for those who took statin while in hospital. We consider the costs and benefits of giving statin to 1,000 heart attack patients when - The cost of the statin treatment is $4,500 per patient. - For simplicity assume that for those whose life is saved exactly one year of life is saved. - The benefit of saving one year of life is placed at $100,000. For simplicity it is assumed that the all of the benefits of statin use occur in the first year. (A) Perform a cost-benefit analysis of the use of statin. Does it favor the use of statin? (B) What is the cost of statin treatment per year of life saved? (C) Now consider quality of life adjusted years. Suppose that all people who experience a heart attack have a lower quality of life after heart attack. It has been calculated that their quality of life adjustment factor is 0.90 (where perfect health is 1.00). What is the cost of statin treatment per quality adjusted year of life saved?
A: A) If statin is used then dies 5% of patients or 50 of 1'000 If statin is NOT used then dies 100% of patients or 100 of 1'000 Benefit = +50 saved lives x 100'000 = 5'000'000 Cost of statin use is 4'500*1'000 = 4'500'000 NET result = Benefit - Cost = 5'000'000 - 4'500'000 = +500'000 B) Cost = 4'500'000 / 50 = $90'000 = Total cost / Quantity who benefited C) $90'000 / 0.9 = $100'000 If we use quality of life adjustment - then there is no benefit and this is situation of zero outcome (if we judge without moral issues) - because benefit equals costs. Another approach is to modify benefit = 100'000*0.9 =$90'000 But not adjusted costs also = 90'000, thus no benefit again.
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