Evidence map›Paper›PMID 17098764›Full record

Trial reportBMJ (Clinical research ed.)2006

Lifetime cost effectiveness of simvastatin in a range of risk groups and age groups derived from a randomised trial of 20,536 people.

Heart Protection Study Collaborative, Borislava Mihaylova, Andrew Briggs, Jane Armitage, Sarah Parish, Alastair Gray, Rory Collins

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ (Clinical research ed.), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
34.0field-weighted citation impact, top 1% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 109 citations in OpenAlex.

  1. Pooled it
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  6. Article
  7. Article
  8. Using QALYs as an Outcome for Assessing Global Prediction Accuracy in Diabetes Simulation Models.Medical decision making : an international journal of the Society for Medical Decision Making · 2025
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  13. Decision Making for Healthcare Resource Allocation: Joint v. Separate Decisions on Interacting Interventions.Medical decision making : an international journal of the Society for Medical Decision Making · 2018
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  15. Social factors and cardiovascular morbidity.Neuroscience and biobehavioral reviews · 2017
    Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Heart Protection Study Collaborative
Borislava Mihaylova
Andrew Briggs
Jane Armitage
Sarah Parish
Alastair Gray
Rory Collins

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo evaluate the cost effectiveness of 40 mg simvastatin daily continued for life in people of different ages with differing risks of vascular disease.

designA model developed from a randomised trial was used to estimate lifetime risks of vascular events and costs of treatment and hospital admissions in the United Kingdom.

setting69 hospitals in the UK.

participants20,536 men and women (aged 40-80) with coronary disease, other occlusive arterial disease, or diabetes.

interventions40 mg simvastatin daily versus placebo for an average of 5 years.

main outcome measuresCost effectiveness of 40 mg simvastatin daily expressed as additional cost per life year gained. Major vascular event defined as non-fatal myocardial infarction or death from coronary disease, any stroke, or revascularisation procedure. Results were extrapolated to younger and older age groups at lower risk of vascular disease than were studied directly, as well as to lifetime treatment.

resultsAt the April 2005 UK price of 4.87 pounds sterling (7 euros; 9 dollars) per 28 day pack of generic 40 mg simvastatin, lifetime treatment was cost saving in most age groups and vascular disease risk groups studied directly. Gains in life expectancy and cost savings decreased with increasing age and with decreasing risk of vascular disease. People aged 40-49 with 5 year risks of major vascular events of 42% and 12% at start of treatment gained 2.49 and 1.67 life years, respectively. Treatment with statins remained cost saving or cost less than 2500 pounds sterling per life year gained in people as young as 35 years or as old as 85 with 5 year risks of a major vascular event as low as 5% at the start of treatment.

conclusionsTreatment with statins is cost effective in a wider population than is routinely treated at present.

Indexed as

AdultAgedAged, 80 and overArterial Occlusive DiseasesCoronary DiseaseCost-Benefit AnalysisDiabetic AngiopathiesFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsLife ExpectancyMaleMiddle AgedQuality-Adjusted Life YearsRisk FactorsSimvastatinHydroxymethylglutaryl-CoA Reductase InhibitorsSimvastatin

Identifiers

PMID17098764
PMCPMC1676106
OpenAlexW1584135845

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.