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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Statin cost-effectiveness in the United States for people at different vascular risk levels
Circulation: Cardiovascular Quality and Outcomes, Volume 2, No. 2, Year 2009
Notification
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Description
Background-Statins reduce the rates of heart attacks, strokes, and revascularization procedures (ie, major vascular events) in a wide range of circumstances. Randomized controlled trial data from 20 536 adults have been used to estimate the cost-effectiveness of prescribing statin therapy in the United States for people at different levels of vascular disease risk and to explore whether wider use of generic statins beyond the populations currently recommended for treatment in clinical guidelines is indicated. Methods and Results-Randomized controlled trial data, an internally validated vascular disease model, and US costs of statin therapy and other medical care were used to project lifetime risks of vascular events and evaluate the cost-effectiveness of 40 mg simvastatin daily. For an average of 5 years, allocation to simvastatin reduced the estimated US costs of hospitalizations for vascular events by ≈ 20% (95% CI, 15 to 24) in the different subcategories of participants studied. At a daily cost of $1 for 40 mg generic simvastatin, the estimated costs of preventing a vascular death within the 5-year study period ranged from a net saving of $1300 (95% CI, $15 600 saving to $13 200 cost) among participants with a 42% 5-year major vascular event risk to a net cost of $216 500 ($123 700 to $460 000 cost) among those with a 12% 5-year risk. The costs per life year gained with lifetime simvastatin treatment ranged from $2500 (-$40 to $3820) in people aged 40 to 49 years with a 42% 5-year major vascular event risk to $10 990 ($9430 to $14 700) in people aged 70 years and older with a 12% 5-year risk. Conclusions-Treatment with generic simvastatin appears to be cost-effective for a much wider population in the United States than that recommended by current guidelines. © 2009 American Heart Association, Inc.
Authors & Co-Authors
Mihaylova, Borislava
Unknown Affiliation
Briggs, Andrew H.
Unknown Affiliation
Collins, Rory
United Kingdom, Oxford
Radcliffe Infirmary
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Meade, Thomas W.
Unknown Affiliation
Sleight, Peter J.
United Kingdom, Oxford
Radcliffe Infirmary
Peto, Richard R.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Simpson, David Martin
Unknown Affiliation
Warlow, Charles P.
United Kingdom, Edinburgh
Western General Hospital
Doll, Richard S.
Unknown Affiliation
Wilhelmsen, Lars W.
Unknown Affiliation
Hill, Catherine
Unknown Affiliation
Sandercock, Peter A.G.
Unknown Affiliation
Benjamin, Nigel B.
United Kingdom, Aberdeen
Aberdeen Royal Infirmary
Carrington, Laura
United Kingdom, Worksop
Bassetlaw Hospital
Shaw, Ali R.G.
Unknown Affiliation
Smith, Eric Edward
Unknown Affiliation
Gill, Paramjit Singh
Unknown Affiliation
Smith, Peter K.
United Kingdom, Bridgend
Princess of Wales Hospital
Lewis, Alan P.
Unknown Affiliation
Brown, Morris J.
Unknown Affiliation
Hudson, Marie Anne R.
Unknown Affiliation
Banks, Merrilyn D.
Unknown Affiliation
Stuart, Robert K.
Unknown Affiliation
Johnston, James Cameron
United Kingdom, Edinburgh
Royal Infirmary of Edinburgh
Lindley, Richard Iain
United Kingdom, Edinburgh
Western General Hospital
United Kingdom, Newcastle
Royal Victoria Infirmary
Campbell, Christina A.
United Kingdom, Glasgow
Glasgow Royal Infirmary
FitzGerald, J. Mark
United Kingdom, Huddersfield
Huddersfield Royal Infirmary
Lewis, Stephanie C.
United Kingdom, Huddersfield
Huddersfield Royal Infirmary
Ball, Stephen Geoffry
United Kingdom, Leeds
Leeds General Infirmary
Prentice, Colin R.M.
United Kingdom, Leeds
Leeds General Infirmary
Hall, Alistair Scott
United Kingdom, Leeds
Leeds General Infirmary
Kooner, Jaspal Singh
Unknown Affiliation
Coats, Andrew J.S.
United Kingdom, London
Royal Brompton Hospital
Davies, E. A.
Unknown Affiliation
Mason, Malcolm David
Unknown Affiliation
Sheppard, James Peter
Unknown Affiliation
Cruickshank, J. Kennedy
Unknown Affiliation
Adams, Phillip C.
United Kingdom, Newcastle
Royal Victoria Infirmary
Thompson, Matt Merfyn
United Kingdom, Newcastle
Royal Victoria Infirmary
Black, Amanda
Unknown Affiliation
Owen, Christopher G.
Unknown Affiliation
Venables, Graham S.
Unknown Affiliation
Bailey, Della
Unknown Affiliation
Thomas, Rebecca L.
United Kingdom, Swansea
Swansea University
Donaldson, Debra D.
Unknown Affiliation
Clements, Mark S.
Unknown Affiliation
Glover, Rachel
Unknown Affiliation
Hall, Kathleen
Unknown Affiliation
Price, Susanna
Unknown Affiliation
Bray, Christopher M.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Corbett, Mark A.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Harwood, Catherine Anne
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Monaghan, Helen
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Macmahon, Stephen W.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Baigent, Colin
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Bowman, Louise J.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Clarke, Robert Joseph
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Dunachie, Susanna J.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Landray, Martin J.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Sudlow, Cathie L.M.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Turnbull, Clare A.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Harding, Peter J.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Sudlow, Cathie L.M.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Charles, Anthony G.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Hill, Jennifer L.
United Kingdom, Oxford
Clinical Trial Service Unit and Epidemiological Studies Unit
Statistics
Citations: 62
Authors: 65
Affiliations: 23
Identifiers
Doi:
10.1161/CIRCOUTCOMES.108.808469
ISSN:
19417713
Study Design
Cross Sectional Study
Study Approach
Quantitative