Evidence mapPaperPMID 34499685Full record

ArticlePloS one2021

Atherosclerotic cardiovascular disease thresholds for statin initiation among people living with HIV in Thailand: A cost-effectiveness analysis.

David C Boettiger, Pairoj Chattranukulchai, Anchalee Avihingsanon, Romanee Chaiwarith, Suwimon Khusuwan, Matthew G Law, Jeremy Ross, Sasisopin Kiertiburanakul

Open access · goldFull text read
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact, top 83% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 6 institutions in 3 countries.

David C BoettigerKirby Institute, UNSW Sydney, Sydney, Australia.ORCID 0000-0002-5951-4503
Pairoj ChattranukulchaiFaculty of Medicine, Division of Cardiovascular Medicine, Chulalongkorn University, Bangkok, Thailand.
Anchalee AvihingsanonHIV-NAT Collaboration/Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
Romanee ChaiwarithResearch Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
Suwimon KhusuwanChiangrai Prachanukroh Hospital, Chiang Rai, Thailand.
Matthew G LawKirby Institute, UNSW Sydney, Sydney, Australia.
Jeremy RossTREAT Asia/amfAR-Foundation for AIDS Research, Bangkok, Thailand.
Sasisopin KiertiburanakulFaculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Chulalongkorn University · THChiang Mai University · THChiangRai Prachanukroh Hospital · THHIV Netherlands Australia Thailand Research Collaboration · THMahidol University · THUNSW Sydney · AU

Funding

IeDEA Asia-Pacific Research CollaborationU01AI069907 · FOUNDATION FOR AIDS RESEARCH · 2025 to 2025
$2.5M
NIAID NIH HHS U01 AI069907
6 · The paper itself

Abstract

backgroundPeople living with HIV (PLHIV) have an elevated risk of atherosclerotic cardiovascular disease (ASCVD) compared to their uninfected peers. Expanding statin use may help alleviate this burden. We evaluated the cost-effectiveness of reducing the recommend statin initiation threshold for primary ASCVD prevention among PLHIV in Thailand.

methodsOur decision analytic microsimulation model randomly selected (with replacement) individuals from the TREAT Asia HIV Observational Database (data collected between 1/January/2013 and 1/September/2019). Direct medical costs and quality-adjusted life-years were assigned in annual cycles over a lifetime horizon and discounted at 3% per year. We assumed the Thai healthcare sector perspective. The study population included PLHIV aged 35-75 years, without ASCVD, and receiving antiretroviral therapy. Statin initiation thresholds evaluated were 10-year ASCVD risk ≥10% (control), ≥7.5% and ≥5%.

resultsA statin initiation threshold of ASCVD risk ≥7.5% resulted in accumulation of 0.015 additional quality-adjusted life-years compared with an ASCVD risk threshold ≥10%, at an extra cost of 3,539 Baht ($US113), giving an incremental cost-effectiveness ratio of 239,000 Baht ($US7,670)/quality-adjusted life-year gained. The incremental cost-effectiveness ratio comparing ASCVD risk ≥5% to ≥7.5% was 349,000 Baht ($US11,200)/quality-adjusted life-year gained. At a willingness-to-pay threshold of 160,000 Baht ($US5,135)/quality-adjusted life-year gained, a 30.8% reduction in the average cost of low/moderate statin therapy led to the ASCVD risk threshold ≥7.5% becoming cost-effective compared with current practice.

conclusionsReducing the recommended 10-year ASCVD risk threshold for statin initiation among PLHIV in Thailand would not currently be cost-effective. However, a lower threshold could become cost-effective with greater preference for cheaper statins.

Indexed as

AtherosclerosisCardiovascular DiseasesCost-Benefit AnalysisDrug CostsFemaleHIV InfectionsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleQuality-Adjusted Life YearsThailandHydroxymethylglutaryl-CoA Reductase Inhibitors

Identifiers

PMID34499685
PMCPMC8428548
OpenAlexW3198114674

What Socratic holds

Textfull text, public
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.