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Centre for Evidence-
Based Medicine

Economic Analysis: Clinical Scenario

Your cardiology unit needs to construct guidelines within a finite budget about which patients are likely to benefit the most from cholesterol-lowering statin drugs. You are aware of the "4S" (Scandinavian simvastatin survival study) that showed reduced mortality for men and women with statins, but this study did not include cost information. You formulate the question, for patients with increased cholesterol: "How much does simvastatin cost per year of life gained?"

You conduct a MEDLINE search for (simvastatin and coronary heart disease and cost effectiveness) as text words, and find a recent study based upon the 4S study New England Journal of Medicine. 1997;336:332-336.

Read the article and decide:

  1. Is this evidence about cost effectiveness valid?
  2. Is this valid evidence about cost effectiveness important in relation to your problem?
  3. Can you apply this valid and important evidence about cost effectiveness to your patients?

Continue to completed worksheet