OBJECTIVE: This study aims to analyze cost-effectiveness of two most-commonly used statins from the perspective of the Korean national health system. METHODS: The scope of the analysis included rosuvastatin (5 mg, 10 mg, and 20 mg) and atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Effectiveness was defined as percentage (%) and absolute (mg/dL) reductions of low-density lipoprotein cholesterol (LDL-C) from the baseline. They were derived from published randomized controlled studies for rosuvastatin and atorvastatin. Effectiveness was defined as reductions in LDL-C levels per mg dose of the drugs. The annual direct medical costs including drug acquisition costs and monitoring costs over the one-year time horizon were calculated for each alternative. The average cost-effectiveness ratios (ACERs) and incremental cost-effectiveness ratios (ICERs) for each statin dose were calculated. RESULTS: The ACERs for all doses of rosuvastatin (5 mg, 10 mg, and 20 mg) were lower than those for all doses of atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Rosuvastatin 10 mg was the most cost-effective statin for LDL-C reduction. In cost-effectiveness analyses for corresponding doses of rosuvastatin and atorvastatin, rosuvastatin was the superior strategy which suggests both higher effectiveness and lower costs than atorvastatin. However, we have to consider this analysis is highly influenced by current price of statins in each market. CONCLUSIONS: For reduction of LDL-C levels in Korean patients with dyslipidemia, rosuvastatin 10mg is the most cost-effective statin in the current Korean market.
Acer ; Atorvastatin Calcium* ; Cholesterol ; Cost-Benefit Analysis* ; Dyslipidemias* ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Lipoproteins ; Rosuvastatin Calcium*

PURPOSE: Statins are known as cholesterol-lowering agents, but have been suggested for the treatment of asthma because of their anti-inflammatory effects. In this study, the potential therapeutic effects of atorvastatin were investigated in asthmatic patients. METHODS: A total of 62 patients with persistent mild to moderate asthma who presented at asthma clinics of Arak University of Medical Sciences were recruited in a double-blind randomized clinical trial. The asthma clinical control score was assessed based on the standardized Asthma Control Test. Lung volume, i.e., percentage of forced expiratory volume in one second (FEV1%) and percentage of forced vital capacity (FVC%), and peripheral blood eosinophils were also measured. The intervention group was treated with atorvastatin 40 mg per day for 8 weeks, while the control group received a placebo. Asthma controller treatments were not changed. At the beginning and end of the study, serum cholesterol and triglyceride levels were measured to evaluate adherence of the patients to the treatment. RESULTS: The asthma control score did not significantly differ between the intervention and control groups (P=0.06). Difference in FEV1%, FVC%, and blood eosinophil count between the intervention and control groups were not statistically significant (P>0.05). The differences in post-treatment cholesterol and low-density lipoprotein cholesterol levels were significant (P<0.05). CONCLUSIONS: Our study shows that atorvastatin is not effective in the treatment of persistent mild to moderate asthma.
Asthma ; Cholesterol ; Eosinophils ; Forced Expiratory Volume ; Heptanoic Acids ; Humans ; Lipoproteins ; Lung ; Pyrroles ; Vital Capacity ; Atorvastatin Calcium

Atorvastatin and ezetimibe are frequently co-administered to treat patients with dyslipidemia for the purpose of low-density lipoprotein cholesterol control. However, pharmacokinetic (PK) drug interaction between atorvastatin and ezetimibe has not been evaluated in Korean population. The aim of this study was to investigate PK drug interaction between two drugs in healthy Korean volunteers. An open-label, randomized, multiple-dose, three-treatment, three-period, Williams design crossover study was conducted in 36 healthy male subjects. During each period, the subjects received one of the following three treatments for seven days: atorvastatin 40 mg, ezetimibe 10 mg, or a combination of both. Blood samples were collected up to 96 h after dosing, and PK parameters of atorvastatin, 2-hydroxyatorvastatin, total ezetimibe (free ezetimibe + ezetimibe-glucuronide), and free ezetimibe were estimated by non-compartmental analysis in 32 subjects who completed the study. Geometric mean ratios (GMRs) with 90% confidence intervals (CIs) of the maximum plasma concentration (C(max,ss)) and the area under the curve within a dosing interval at steady state (AUC(τ,ss)) of atorvastatin when administered with and without ezetimibe were 1.1087 (0.9799–1.2544) and 1.1154 (1.0079–1.2344), respectively. The corresponding values for total ezetimibe were 1.0005 (0.9227–1.0849) and 1.0176 (0.9465–1.0941). There was no clinically significant change in safety assessment related to either atorvastatin or ezetimibe. Co-administration of atorvastatin and ezetimibe showed similar PK and safety profile compared with each drug alone. The PK interaction between two drugs was not clinically significant in healthy Korean volunteers.
Atorvastatin Calcium* ; Cholesterol ; Cross-Over Studies ; Drug Interactions* ; Dyslipidemias ; Ezetimibe* ; Humans ; Lipoproteins ; Male ; Pharmacokinetics ; Plasma ; Volunteers*

Atorvastatin Calcium ; Eosinophilia ; chemically induced ; Heptanoic Acids ; adverse effects ; Humans ; Male ; Middle Aged ; Pyrroles ; adverse effects

No abstract available.
Diabetes Mellitus, Type 2 ; Heptanoic Acids ; Humans ; Hypercholesterolemia ; Pyrroles ; Retrospective Studies ; Atorvastatin Calcium

No abstract available.
Diabetes Mellitus, Type 2 ; Heptanoic Acids ; Humans ; Hypercholesterolemia ; Pyrroles ; Retrospective Studies ; Atorvastatin Calcium

BACKGROUND: The proportion of pharmaceutical expenditure out of total health-care expenditure in South Korea is high. In 2016, 25.7% of national health insurance (NHI) spending was for pharmaceuticals. Given the increasing demands for the access to newly introduced medicines and following increase in pharmaceutical spending, the management of NHI pharmaceutical expenditure is becoming more difficult. METHODS: This study analyzed the data claimed to NHI for pharmaceutical reimbursement from 2010 to 2016. RESULTS: The policy implications with respect to the trends and problems in spending by drug groups were elicited. First, the proportion of off-patent drugs spending which were treated to chronic disease was much higher than anti-cancer drug spending. Second, the spending to the newly introduced high-costed medicine increased, however, current price-reduction mechanism was not sufficient to manage their expenditure efficiently. CONCLUSION: Our system seems to need several revisions to improve the efficiency of pharmaceutical expenditure and to cope with high-costed medicines. This study suggested that the prices of off-patent drugs need to be regularly readjusted and the Price-Volume Agreement System should be operated more flexibly as well.
Atorvastatin Calcium ; Chronic Disease ; Health Expenditures ; Imatinib Mesylate ; Korea ; National Health Programs

Blastocystis is an enteric Straminopile in tropical, subtropical and developing countries. Metronidazole has been a chemotheraputic for blastocystosis. Failures in its regimens were reported and necessitate new studies searching for alternative therapeutic agents. Aim of current study is to investigate potential effects of Atorvastatin (AVA) compared to the conventional chemotherapeutic MTZ in experimentally Blastocystis-infected mice. Anti-Blastocystis efficacy of AVA was evaluated parasitologically, histopathologically and by transmission electron microscopy using MTZ (10 mg/kg) as a control. Therapeutic efficacy of AVA was apparently dose-dependent. Regimens of AVA (20 and 40 mg/kg) proved effective against Blastocystis infections with high reduction in Blastocystis shedding (93.4–97.9%) compared to MTZ (79.3%). The highest reductions (98.1% and 99.4%) were recorded in groups of combination treatments AVA 20–40 mg/kg and MTZ 10 mg/kg. Blastocystis was nearly eradicated by the 20th day post infection. Genotype analysis revealed that genotype I was most susceptible, genotype III was less. Histopathologic and ultrastructural studies revealed apoptotic changes in Blastocystis and significant improvement of intestinal histopathological changes more remarkable in combinational therapy groups. Thus, the present study offers AVA as a potential candidate for Blastocystis therapy combined with MTZ.
Animals ; Atorvastatin Calcium ; Blastocystis ; Blastocystis Infections ; Developing Countries ; Genotype ; Metronidazole ; Mice ; Microscopy, Electron, Transmission

BACKGROUND AND OBJECTIVES: Although the rate of prescribing hydroxylmethyglutaryl-CoA reductase inhibitors (statin) has recently increased, there is a large treatment gap between the guidelines and actual clinical practice. We studied the effect of high potency statin on the percentage of patients who achieve the target low density lipoprotein (LDL) cholesterol level, and we determined the changes of lipid profiles with using 10 mg of rosuvastatin and 20 mg of atorvastatin. MATERIALS AND METHODS: 222 consecutive patients with acute coronary syndrome or acute ischemic stroke were randomly assigned to either the group treated with rosuvastatin 10 mg (Group I) or atorvastatin 20 mg (Group II). We compared the percentage of patients who achieved the target LDL cholesterol level, and the percent change of the serum lipid profile from baseline to the 40th week between the two groups. RESULTS: 117 (52.7%) patients completed this study. When the target LDL cholesterol level was <100 mg/dL, there was no significant difference in the target attainment rate between the two groups (86.7% vs. 77.2%; respectively, p=0.182). When the target LDL cholesterol level was <70 mg/dL, 48.3% of Group I and 29.8% of Group II reached the goal (p=0.040). The LDL cholesterol level was reduced by 46.8% in Group I (p<0.001), and by 40.1% in Group II (p<0.001). However, the final level showed a trend to be lower in the rosuvastatin group (p=0.077). There were no serious side effects in both groups. The study drug was discontinued due to adverse events in 2 patients (2.6%) of Group I, and in 3 patients (3.8%) of Group II (p=0.523). CONCLUSION: This study showed that the reduction of LDL cholesterol was not statistically different between rosuvastatin 10 mg and atorvastatin 20 mg. However, fewer than half of the patients achieved the goal in both groups despite of high potency statin therapy. This suggests that more aggressive statin therapy is preferred for high risk patients.
Acute Coronary Syndrome ; Cholesterol ; Cholesterol, LDL ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* ; Lipoproteins ; Oxidoreductases ; Stroke ; Atorvastatin Calcium ; Rosuvastatin Calcium

BACKGROUND AND OBJECTIVES: High C-reactive protein (CRP) levels are associated with an increased risk of cardiovascular diseases. The hydroxymethyl glutaryl Coenzyme A reductase inhibitors (statin) lowers the CRP level in the population of developed countries. The aim of the study was to evaluate the effect of statin on the CRP levels in Korean hypercholesterolemic patients without atherosclerotic diseases. SUBJCETS AND METHODS: A total of 32 patients with hypercholesterolemia, administered 20 mg lovastatin or 10 mg atorvastatin, and the same number of similar aged, sex-matched, hypercholesterolemic patients, as a control group, were enrolled. Non-drug measures were recommended for those without the medication. The patients with atherosclerotic cardiovascular diseases were excluded. The lipid profiles and high sensitive CRP levels were measured before and after 2 months of the medication. RESULTS: The baseline CRP levels were not related to the levels of lipids. Statin therapy reduced the CRP levels from 2.17+/-2.40 (median value 1.11) mg/L to 1.24+/-1.79 (0.68) mg/L (p=0.003). In all the cases, the magnitude of change in the CRP was related to the statin therapy allocation and the magnitude of changes in the total and low density lipoprotein cholesterols in a univariate analysis. Multiple stepwise regression analysis showed that only the statin therapy allocation was an independent variable. For each group, no significant relationship between the changes of CRP and lipids was observed. CONCLUSION: Short term statin therapy reduced the CRP levels in Korean hypercholesterolemic patients without atherosclerotic diseases, and the phenomenon was independent of the changes in lipids.
C-Reactive Protein* ; Cardiovascular Diseases ; Cholesterol, LDL ; Coenzyme A* ; Developed Countries ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia ; Lovastatin ; Oxidoreductases* ; Atorvastatin Calcium