総コレステロール高値の治療者データを利用した高脂血症治療薬の死亡率への影響とその経済評価

• 亀 千保子

  九州大学大学院医学系学府医療経営管理学専攻

• 馬場園 明

  九州大学大学院医学研究院医療経営管理学講座

• 山本 英二

  岡山理科大学総合情報学部情報科学科

書誌事項

タイトル別名

• Estimation of Effect of Lipid Lowering Treatment on Total Mortality Rate and Its Cost-Effectiveness Determined by Intervention Study of Hypercholesterolemia
• ソウ コレステロール コウチ ノ チリョウシャ データ オ リヨウ シタ コウシケツショウ チリョウヤク ノ シボウリツ エ ノ エイキョウ ト ソノ ケイザイ ヒョウカ

抄録

Objectives: Total cholesterol (TC) level reduction decreases coronary heart disease (CHD) risk, but it is also associated with an increase in non-CHD mortality rate. Our objectives are to estimate the effect of TC level reduction on total mortality and other mortalities in the Japanese population using published data and to analyze the cost-effectiveness of drug therapy.<br>Methods: We analyzed three data sets for the estimation. The first data set comprised Japanese mortality rates of cardiac diseases, cerebrovascular/other vascular diseases, malignancy, and all causes according to sex and age. The second data set comprised the distributions of serum TC levels in the Japanese population. The third data set comprised the relative risks of mortality rates for the above causes according to the TC level classified into discrete intervals of 20mg/dl from an intervention study. We estimated the mortality rates of people aged 30-69, with each TC level classification group on the basis of each cause. On the assumption that TC level decreases from 240-259mg/dl to 160-179mg/dl or 180-199mg/dl with drug therapy, we calculated the differences between the mortalities of the classification. When we found a positive effect of TC level reduction, we performed cost-effectiveness analyses of Number Needed to Treat (NNT).<br>Results: TC level reduction increased the mortality rates except for that of cardiac diseases, and the NNT for cardiac diseases was in the range of 4,202-17,533. The cost of simvastatin, for example, was 0.25-1.05 billion yen per year.<br>Conclusions: TC level reduction from 240-259mg/dl to 160-199mg/dl leads to an increase in total mortality rate in the Japanese population. The treatment should be reevaluated from both viewpoints of risk benefit and cost-effectiveness.

収録刊行物

• 日本衛生学雑誌

  日本衛生学雑誌 62 (1), 39-46, 2007

  一般社団法人日本衛生学会

キーワード

• 高脂血症治療
• 総コレステロール
• 総死亡率
• 費用効果

詳細情報

• CRID: 1390001206362995968
• NII論文ID: 10018539469
• NII書誌ID: AN00185923
• DOI: 10.1265/jjh.62.39
• COI: 1:STN:280:DC%2BD2s7jsFOjsw%3D%3D
• ISSN: 18826482
• ISSN: 00215082
• NDL書誌ID: 8689438
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I8689438
• Web Site: http://www.jstage.jst.go.jp/article/jjh/62/1/62_1_39/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2007264271
• 本文言語コード: ja
• データソース種別:
  • JaLC
  • NDL
  • Crossref
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可