Are statins cost-effective as primary prevention?

January 01, 0001

Are statins cost-effective as primary prevention?

The JUPITER trial has demonstrated the efficacy of statins in the primary prevention of heart disease. These Dutch researchers examined the cost- effectiveness of statins for such primary prevention. They used a Markov model, sensitivity analysis and Monte Carlo simulation using hypothetical populations of men and women at varying risk of vascular disease. .

The researchers found: "Over a 10-year period, statin treatment cost €35,000 (£30,000, $49,000) per quality-adjusted life-years (QALY) gained for men aged 55 years with a 10-year vascular risk of 10%. The incremental cost- effectiveness ratio improved as risk for vascular disease increased. The cost per QALY ranged from approximately €5000 to €125,000 when the 10-year vascular risk for men aged 55 years was varied from 25% to 5%. The incremental cost- effectiveness ratio slightly decreased with age after the level of vascular risk was specified. Results were sensitive to the costs of statin treatment, statin effectiveness, non-adherence, disutility of taking medication daily, and the time horizon of the model."

The researchers concluded: "In daily practice, statin treatment seemed not to be cost-effective for primary prevention in populations at low risk of vascular disease, despite low costs of generic drug pills. Adherence to statin treatment needs to be improved to enhance the cost-effectiveness of the use of statins for primary prevention."

This study caution that statin, although they do provide a benefit in primary prevention of vascular disease, may not be cost effective in low risk populations.

For the full abstract, click here.

BMJ 342:d1672, 30 March 2011
© 2011 BMJ Publishing Group Ltd.
Statin treatment for primary prevention of vascular disease: whom to treat? Cost-effectiveness analysis. JP Greving, FLJ Visseren, GA de Wit, A Algra. Correspondence to J P Greving: [email protected]

Category: K. Circulatory. Keywords: statin, primary prevention, vascular disease, cardiovascular risk, low-dose, cost-effective analysis, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 19 April 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.