ArticleHeart (British Cardiac Society)1999
Cost effectiveness of HMG-CoA reductase inhibitor (statin) treatment related to the risk of coronary heart disease and cost of drug treatment.
Article in Heart (British Cardiac Society), 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 2 syntheses or guidelines pooled it, 109 citations in OpenAlex.
- A Systematic Review of Cardiovascular Outcomes-Based Cost-Effectiveness Analyses of Lipid-Lowering Therapies.PharmacoEconomics · 2017Pooled it
- Economic evaluations of cholesterol-lowering drugs: a critical and systematic review.PharmacoEconomics · 2007Pooled it
- Probiotic potential of ginseng derived Lacticaseibacillus rhamnosus strains with hypocholesterolemic, antioxidant and antibacterial activities.Scientific reports · 2025Article
- The Cost-Benefit Balance of Statins in Hawai'i: A Moving Target.Hawai'i journal of medicine & public health : a journal of Asia Pacific Medicine & Public Health · 2017Article
- Cost-effectiveness of high, moderate and low-dose statins in the prevention of vascular events in the Brazilian public health system.Arquivos brasileiros de cardiologia · 2015Article
- Preventing cardiovascular disease among Canadians: is the treatment of hypertension or dyslipidemia cost-effective?The Canadian journal of cardiology · 2008Article
- Microbial production and biomedical applications of lovastatin.Indian journal of pharmaceutical sciences · 2008Article
- Managing hypercholesterolemia and its correlation with carotid plaque morphology in patients undergoing carotid endarterectomy.Vascular health and risk management · 2008Article
- A review of health care models for coronary heart disease interventions.Health care management science · 2006Review
- Effectiveness calculation in economic analysis: the case of statins for cardiovascular disease prevention.Journal of epidemiology and community health · 2006Article
- Evidence-based prescribing of statins: a developing world perspective.PLoS medicine · 2006Article
- Cost effectiveness of adding ezetimibe to atorvastatin therapy in patients not at cholesterol treatment goal in Canada.PharmacoEconomics · 2006Article
- Cost effectiveness of statins in coronary heart disease.Journal of epidemiology and community health · 2005Review
- The influence of guidelines on the use of statins: analysis of prescribing trends 1998-2002.British journal of clinical pharmacology · 2005Article
- High prevalence and undertreatment of hypercholesterolaemia in participants in a public stroke prevention programme in austria.Clinical drug investigation · 2005Article
- [Primary prevention of coronary heart disease? What is cost effective in the clinical practice?].Zeitschrift fur Kardiologie · 2005Article
- Paying for statins.BMJ (Clinical research ed.) · 2004Article
- Cost effectiveness and cost utility model of public place defibrillators in improving survival after prehospital cardiopulmonary arrest.BMJ (Clinical research ed.) · 2003Article
- Physicians' ability to predict the risk of coronary heart disease.BMC health services research · 2003Article
- Introduction to health economics for the medical practitioner.Postgraduate medical journal · 2003Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo estimate the cost effectiveness of statin treatment in preventing coronary heart disease (CHD) and to examine the effect of the CHD risk level targeted and the cost of statins on the cost effectiveness of treatment.
designCohort life table method using data from outcome trials.
main outcome measuresThe cost per life year gained for lifelong statin treatment at annual CHD event risks of 4.5% (secondary prevention) and 3.0%, 2.0%, and 1.5% (all primary prevention), with the cost of statins varied from pound 100 to pound 800 per year.
resultsThe costs per life year gained according to annual CHD event risk were: for 4.5%, pound 5100; 3.0%, pound 8200; 2.0%, pound 10 700; and 1.5%, pound 12 500. Reducing the cost of statins increases cost effectiveness, and narrows the difference in cost effectiveness across the range of CHD event risks.
conclusionsAt current prices statin treatment for secondary prevention, and for primary prevention at a CHD event risk 3.0% per year, is as cost effective as many treatments in wide use. Primary prevention at lower CHD event risks (< 3.0% per year) is less cost effective and unlikely to be affordable at current prices and levels of health service funding. As the cost of statins falls, primary prevention at lower risk levels becomes more cost effective. However, the large volume of treatment needed will remain a major problem.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.