1.10. In 2007, the online medical journal Circulation published a study that analyzed the cost-effectiveness of standard-dosage versus high-dosage amounts of statins, drugs designed to lower cholesterol. Patients of approximately 60 years of age were divided into two groups: ACS, or acute coronary syndrome, patients who had recently suffered a heart attack or chest pains severe enough for hospitalization; and CAD, or stable coronary artery disease, patients who had less severe cases of heart disease. The benefit of a dose of statins was measured in terms of the number of additional years of lifespan lived in a quality way—or QALYs (Quality-Adjusted Life Years). The table below gives some data from the study, where for each group, the outcome from the standard dose was the baseline.

In the following table, we have posed two assumptions about the value of a QALY: in the first case it is worth $30,000 and in the second case it is worth $50,000. We have assumed that ACS patients live an average of 6 additional years with the high dose than with the standard dose, and CAD patients live an average of 10 additional years with the high dose than with the standard dose. Both sets of patients must take the high dose for their entire future life span to receive the additional QALY benefits from it. We have also made two assumptions about the additional cost of a high dose versus a standard dose of statin: in the first case the high dose costs an additional $3.50 per day and in the second case the high dose costs an additional $1.25 per day. In the empty cells in the table, indicate whether the high dose therapy should be prescribed from weighing its marginal benefits and marginal costs. Explain your choices. Disregard the fact that some benefits and costs arrive at different times. Also assume that all years have 365 days (i.e., no leap years).

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ACS Standard dose High dose Baseline CAD Baseline Additional 0.35 QALY Additional 0.096 QALY