Circulation: Statins for the prevention of cardiovascular disease, benefit more than 10 years!

Cholesterol guidelines generally prioritize primary prevention statin therapy based on 10-year cardiovascular disease risk
.

The advent of generic drug prices may justify expanding eligibility for statins

Cholesterol guidelines generally prioritize primary prevention statin therapy based on 10-year cardiovascular disease risk

The researchers designed a computer simulation model to predict long-term health and cost outcomes in Scottish adults aged ≥40 years
.

Epidemiological analyses were completed using the Scottish Heart Health Expansion Cohort, Scottish Incidence Records, and Scottish National Records

The primary outcome measure was the lifetime incremental cost-effectiveness ratio (ICER), estimated as the cost per quality-adjusted life-year (QALY) acquired
.

Three approaches to prioritizing statins were analyzed: 10-year risk score using ASSIGN score, age-stratified (Age-Strat) risk threshold to increase treatment rates in younger individuals, and absolute risk reduction (ARR) to guide treatment to Increase treatment rates in individuals with elevated cholesterol levels

Results showed that the policy, compared with ASSIGN 20, lowered the risk threshold for statin initiation to 10%, expanding eligibility from 804,000 (32% of adults ≥40 years of age without cardiovascular disease) to 1,445,500 (58 %)
.

This policy will be cost effective (ICER: £12,300/QALY, 95% CI: £7,690/QALY - £26,500/QALY)

This policy will be cost effective (ICER: £12,300/QALY, 95% CI: £7,690/QALY - £26,500/QALY)

Furthermore, the delta of ARR 10 yielded around 7,950 QALYs compared to ASSIGN 10, which is cost-effective (£11,700/QALY, 95% CI: £9,250/QALY - £16,900/QALY)
.

Both age-stratified risk threshold strategies were dominant (ie, more expensive and less effective than other treatment strategies)

Furthermore, the delta of ARR 10 yielded around 7,950 QALYs compared to ASSIGN 10, which is cost-effective (£11,700/QALY, 95% CI: £9,250/QALY - £16,900/QALY) Furthermore, compared to ASSIGN 10 , an increment of ARR 10 yielded about 7,950 QALYs, cost-effective (£11,700/QALY, 95% CI: £9,250/QALY - £16,900/QALY)

Taken together, generic pricing makes prophylactic statin therapy cost-effective for many adults
.

Treatment guided by absolute risk reduction is more effective and cost-effective than the 10-year risk score

Taken together, generic pricing makes prophylactic statin therapy cost-effective for many adults

references:

Beyond Ten-Year Risk: A Cost-Effectiveness Analysis of Statins for the Primary Prevention of Cardiovascular Disease.

leave a message here