Statin therapy cost-effective for a wider range of individuals

Statin therapy is cost-effective for a wider range of individuals with vascular disease or diabetes than previously recognised, concludes a study published online today (Thursday May 12, 2005) by THE LANCET.

Current guidelines generally recommend the initiation of statin therapy when the estimated 10-year risk of a non-fatal heart attack or coronary death is at least 15-20%.

The Heart Protection Study (HPS) has previously shown that lowering cholesterol concentrations with 40mg of simvastatin daily produces substantial reductions not just in the rates of such coronary events, but also in the rates of strokes and revascularisation procedures among a wide-range of high-risk individuals, irrespective of their pre-treatment blood cholesterol concentrations. In the HPS, over 20,500 adults aged 40-80 years with vascular disease or diabetes were randomly assigned to 40mg of simvastatin daily or a placebo. In the latest study the HPS researchers compared the costs of hospitalisations and statin therapy between the two groups, and estimated the cost-effectiveness for participants with varying levels of vascular disease risk.

They found a 22% relative reduction in the costs of hospitalisations for vascular events in the statin group, with similar proportional reductions in every sub-category of patients studied. Overall, the cost of avoiding a major vascular event was estimated to be 11,600, but there was substantial variation between the risk subgroups. For example, among individuals with a 42% 5-year risk of a major vascular event, the estimated cost-effectiveness was 4,500 per major vascular event avoided. By contrast, among those with a 12% 5-year risk, it was estimated to be 31,100. The authors believe that initiation of statin therapy should now be considered for people at lower risk for coronary or other major vascular events than is currently recommended.

Professor Rory Collins (Clinical Trial Service Unit, University of Oxford, UK), p

Contact: Joe Santangelo

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