More People Could Benefit From Statins

Study Shows Lipid-Lowering Drugs Cost-effective for Most Patients

Medically Reviewed by Louise Chang, MD on November 09, 2006
From the WebMD Archives

Nov. 9, 2006 -- Cholesterol-lowering statin therapy is both beneficial and cost-effective for a wider range of the population than has previously been treated with the drugs, a new study suggests.

Researchers from the University of Oxford who conducted a cost analysis of statins concluded that even people with relatively low heart attack or stroke should be considered for treatment.

They found treatment with a generic statin to be cost-effective, even for people as young as 35 or as old as 85, whose annual risk of having a major heart or stroke event was as little as 1%.

This is well below the treatment threshold normally recommended in Europe and the U.S.

"We know that statins are very effective for reducing the risks associated with cardiovascular disease," senior researcher Jane Armitage of the Heart Protection Study tells WebMD. "As these drugs come off patent and become cheaper, they should be considered for a wider population."

Generic Choices Growing

Millions of people currently take statin drugs like Crestor, Lescol, Lipitor, Pravachol, or Zocor to lower their LDL "bad" cholesterol and reduce their risk of having a heart attack, stroke, or other cardiovascular event.

Two new generic versions of the drugs recently became available in the U.S. Zocor is now sold generically as simvastatin and Pravachol is sold generically as pravastatin. The generic statin lovastatin is also widely prescribed.

According to a recent investigation from the Consumers Union, which publishes the magazine Consumer Reports, generic statins could save patients in the U.S. as much as $1,800 per year.

The UK Heart Protection Study included 20,536 patients with heart disease, other disease with artery blockage such as stroke, or diabetes who were treated for an average of five years with 40 milligrams daily of simvastatin or placebo. Study participants ranged in age from 40 to 80.

Last year, Armitage and colleagues reported that treatment for several years was cost-effective for a wide range of people with established heart disease, stroke, or diabetes when cheaper, generic statins are used.

Using data from the study, the researchers estimated the lifetime cost-effectiveness of statin use among people who were both younger and healthier than the people recruited for the study.

Younger, high-risk patients were found to benefit the most from lifetime statin use, in terms of life expectancy. But even young people at moderate risk benefited, researchers concluded.

The estimated cost per year of life gained ranged from $858 to $4,700 for people with a 5%, five-year risk of having a major cardiovascular event (between ages of 35 to 85) at the start of treatment.

In their latest report, published online Friday in the journal BMJ, the study group concluded that over the course of a lifetime, treatment with generic statins actually saves health care dollars or is cost-effective for many more people than previously thought.

Important Contribution

Cardiologist Sidney C. Smith Jr., MD, tells WebMD that the study makes an important contribution to the literature.

Smith, who is a former president of the American Heart Association (AHA), leads an AHA/American College of Cardiology task force examining practice guidelines. He is a professor of medicine at the University of North Carolina.

"The first standard of treatment is always determining if there is a benefit," he says. "Once a benefit is shown, the question becomes, 'How much does it cost to recognize this benefit?' These investigators show that treatment with a generic statin is a very cost-effective way to lower risk, even among patients who are at the lower end of moderate risk."

But even with the growing array of effective preventive therapies, Smith emphasizes that lifestyle remains a big part of the prevention strategy.

"Lifestyle changes must be the foundation for everything we do," he says. "That means getting people to stop smoking, eat right, and exercise. We have to make sure that patients know that lifestyle is as important as it ever was."

Not everyone may be able to take statins due to other medical conditions such as liver disease. Side effects may include abnormal liver function, muscle aches, muscle damage, allergic reaction, dizziness, abdominal pain, or constipation.

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SOURCES: Heart Protection Study, BMJ Online, Nov. 10, 2006. Jane Armitage, senior researcher, Clinical Trial Service Unit, University of Oxford. Sidney C. Smith Jr., MD, professor of medicine, University of North Carolina; former president, American Heart Association. News release, Consumers Union.

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