Statin therapy for prevention of cardiovascular disease
A new study has found that Scotland should expand access to statin therapy for the primary prevention of cardiovascular disease. In addition, focusing on patients’ cholesterol levels alongside their 10-year cardiovascular risk was determined to be a cost-effective way to prioritize statin therapy.
The paper, titled "Beyond Ten-Year Risk: A Cost-Effectiveness Analysis of Statins for the Primary Prevention of Cardiovascular Disease” and published in March 2022 in Circulation was authored by IHW researchers Dr Ciaran Kohli-Lynch, Professor Jim Lewsey, Dr Kathleen Boyd, Professor Naveed Sattar, and Professor Andrew Briggs.
It employed a computer simulation model to predict the long-term health and cost consequences of statin treatment in subsets of the Scottish population.
IHW visiting research assistant Ciaran Kohli-Lynch said:
"The advent of generic pricing has rendered statins cost-effective for many more people than currently recommended by Scottish clinical guidelines. In addition, current guidelines focus on patients’ ten-year risk of experiencing a cardiovascular disease event. Ten-year risk is often determined by non-modifiable risk factors like age. Evidence from clinical trials shows that statins are relatively more effective at reducing cardiovascular risk in patients with high baseline cholesterol. By adopting an ‘absolute risk reduction’ approach to patient prioritization, policymakers could prevent more cases of coronary heart disease and stroke and improve population health in a cost-effective manner."
The study predicted that reducing the ten-year risk threshold for statin initiation from 20% to 10% would expand eligibility from 32% to 58% of CVD-free adults aged ≥40 years, prevent around 28,000 cases of heart disease and stroke, produce 69,000 quality-adjusted life years, and would be cost-effective. Using absolute risk reduction (based on baseline cholesterol and ten-year risk) to prioritize treatment in this proportion of the population would produce an additional 8,000 quality-adjusted life years and would be cost-effective.
First published: 18 April 2022