HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Cost-effectiveness of statin therapy for primary prevention in a low-cost statin era.

AbstractBACKGROUND:
With wide availability of low-cost generics, primary prevention with statins has become less expensive. We projected the cost-effectiveness of expanded statin prescribing strategies using low-cost generics and identified conditions under which aggressive prescribing ceases to be cost-effective.
METHODS AND RESULTS:
We simulated expanded statin prescribing strategies with the coronary heart disease policy model, a Markov model of the US population >35 years of age. If statins cost $4/mo, treatment thresholds of low-density lipoprotein cholesterol >160 mg/dL for low-risk persons (0 to 1 risk factor), >130 mg/dL for moderate-risk persons (≥2 risk factors and 10-year risk <10%), and >100 mg/dL for moderately high-risk persons (≥2 risk factors and 10-year risk >10%) would reduce annual healthcare costs by $430 million compared with Adult Treatment Panel III guidelines. Lowering thresholds to >130 mg/dL for persons with 0 risk factors and >100 mg/dL for persons with 1 risk factor and treating all moderate- and moderately high-risk persons regardless of low-density lipoprotein cholesterol would provide additional health benefits for $9900 per quality-adjusted life-year. These findings are insensitive to most adverse effect assumptions (including statin-associated diabetes mellitus and severe hypothetical effects) but are sensitive to large reductions in the efficacy of statins or to a long-term disutility burden for which a patient would trade 30 to 80 days of life to avoid 30 years of statins.
CONCLUSIONS:
Low-cost statins are cost-effective for most persons with even modestly elevated cholesterol or any coronary heart disease risk factors if they do not mind taking a pill daily. Adverse effects are unlikely to outweigh benefits in any subgroup in which statins are found to be efficacious.
AuthorsLawrence D Lazar, Mark J Pletcher, Pamela G Coxson, Kirsten Bibbins-Domingo, Lee Goldman
JournalCirculation (Circulation) Vol. 124 Issue 2 Pg. 146-53 (Jul 12 2011) ISSN: 1524-4539 [Electronic] United States
PMID21709063 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol
Topics
  • Adult
  • Aged
  • Cholesterol (blood)
  • Coronary Disease (drug therapy, economics)
  • Costs and Cost Analysis
  • Diabetes Mellitus (chemically induced, economics, therapy)
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors (adverse effects, economics, therapeutic use)
  • Middle Aged
  • Models, Biological
  • Practice Guidelines as Topic
  • Risk Factors
  • Time Factors
  • United States

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: