Evidence map›Paper›PMID 38549731›Full record

ArticleThe Lancet regional health. Europe2024

Lifetime effects and cost-effectiveness of standard and higher-intensity statin therapy across population categories in the UK: a microsimulation modelling study.

Borislava Mihaylova, Runguo Wu, Junwen Zhou, Claire Williams, Iryna Schlackow, Jonathan Emberson, Christina Reith, Anthony Keech, John Robson, Richard Parnell and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet regional health. Europe, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

17 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Biological effects of statins in systemic sclerosis: a systematic review and meta-analysis of 323 patients.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2026
    Pooled it
  2. Pooled it
  3. Review
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  8. Review
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  11. Association Between Statin Use and Glaucoma Risk: A Population-Based Study.Investigative ophthalmology & visual science · 2025
    Article
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  13. Review
  14. Therapeutic Management of LDL-C: Efficacy and Economic Impact Assessment.Journal of cardiovascular development and disease · 2025
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Borislava MihaylovaHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Runguo WuHealth Economics and Policy Research Unit, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Junwen ZhouHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Claire WilliamsHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Iryna SchlackowHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Jonathan EmbersonClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Christina ReithClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Anthony KeechNHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
John RobsonClinical Effectiveness Group, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Richard ParnellPatient and Public Representative, UK.
Jane ArmitageClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Alastair GrayHealth Economics Research Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
John SimesNHMRC Clinical Trials Centre, University of Sydney, Sydney, Australia.
Colin BaigentClinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Funding

British Heart Foundation CH/1996001/9454British Heart Foundation PG/18/16/33570
6 · The paper itself

Abstract

Background: Cardiovascular disease incidence and mortality have declined across developed economies and granular up-to-date cost-effectiveness evidence is required for treatments targeting large populations. To assess the health benefits and cost-effectiveness of standard and higher intensity statin therapy in the contemporary UK population 40-70 years old. Methods: A cardiovascular disease microsimulation model, developed using the Cholesterol Treatment Trialists' Collaboration data (117,896 participants; 5 years follow-up), and calibrated in the UK Biobank cohort (501,854 participants; 9 years follow-up), projected risks of myocardial infarction, stroke, coronary revascularization, diabetes, cancer and vascular and nonvascular death for all UK Biobank participants without and with statin treatment. Meta-analyses of trials and cohort studies informed statins' relative effects on cardiovascular events, incident diabetes, myopathy and rhabdomyolysis. UK healthcare perspective was taken (2020/2021 UK£) with costs per 28 tablets of £1.10 for standard (35%-45% LDL cholesterol (LDL-C) reduction) and £1.68 for higher intensity (≥45% LDL-C reduction) generic statin. Findings: Across categories by sex, age, LDL-C, and cardiovascular disease history/10-year cardiovascular risk, lifetime standard statin increased survival by 0.28-1.85 years (0.20-1.09 quality-adjusted life years (QALYs)), and higher intensity statin by further 0.06-0.40 years (0.03-0.20 QALYs) per person. Standard statin was cost-effective across all categories with incremental cost per QALY from £280 to £8530, with higher intensity statin cost-effective at higher cardiovascular risks and higher LDL-C levels. Stopping statin early reduced benefits and was not cost-effective. Interpretation: Lifetime low-cost statin therapy is cost-effective across all 40-70 years old in UK. Strengthening and widening statin treatment could cost-effectively improve population health. Funding: UK NIHR Health Technology Assessment Programme (17/140/02).

Indexed as

Cardiovascular diseasesCost-effectivenessHealth care costsMicrosimulation modelQuality-adjusted life yearsStatin

Identifiers

PMID38549731
PMCPMC10973720

What OpenQuestion holds

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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.