Cholesterol lowering ‘statin’ drugs are cost effective in far more people than current guidelines recommend and should be considered for a wider range of people, say researchers in a study published online by the BMJ today.
Large trials have shown that lowering blood cholesterol levels with statins greatly reduces major vascular events, such as heart attacks and strokes, in people at high risk.
And research published in 2005 from the largest of those trials (the heart protection study) showed that when cheaper generic versions are used, several years of statin treatment is cost effective for a wide range of people with vascular disease or diabetes.
The heart protection study involved 20,536 men and women presenting at age 40-80 with heart disease or diabetes. They were randomly allocated to receive either 40 mg simvastatin daily or placebo for an average of 5 years.
Using data from this study, the researchers have now estimated the lifetime cost effectiveness of 40 mg simvastatin daily for people in an even wider range of age and underlying vascular risk categories.
The research team found that treatment with generic simvastatin would be cost saving for most of the age and risk categories included in the heart protection study. In other words, the reduced costs of hospital admissions as a result of fewer vascular events outweighed the increased costs of statin treatment in almost all of the categories studied.
In fact, they found that statin treatment was cost effective in people as young as 35 and as old as 85 with an annual risk of a major vascular event as low as 1%. This is well below the risk threshold currently recommended by the National Institute for Health and Clinical Excellence (NICE).
These new analyses indicate that, at current generic prices, lifelong treatment with simvastatin is cost saving or very cost effective for many more people than previously thought, say the authors.
Hence, statin therapy should be considered routinely for people across a wider age range and at lower risk of vascular disease than is currently the case.
Revision date: July 3, 2011
Last revised: by Andrew G. Epstein, M.D.