Evidence map›Paper›PMID 39256053›Full record

ArticleHeart (British Cardiac Society)2024

Lifetime effects and cost-effectiveness of statin therapy for older people in the United Kingdom: a 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 Heart (British Cardiac Society), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
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 boby.mihaylova@dph.ox.ac.uk.ORCID 0000-0002-0951-1304
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.ORCID 0000-0002-4154-1431
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, The University of Sydney, Sydney, New South Wales, Australia.
John RobsonClinical Effectiveness Group, Wolfson Institute of Population Health, Queen Mary University of London, London, UK.
Richard ParnellPatient and Public Representative, Havant, 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.ORCID 0000-0003-0239-7278
John SimesNHMRC Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, 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/18/16/33570Medical Research Council MC_UU_00017/4
6 · The paper itself

Abstract

backgroundCardiovascular disease (CVD) risk increases with age. Statins reduce cardiovascular risk but their effects are less certain at older ages. We assessed the long-term effects and cost-effectiveness of statin therapy for older people in the contemporary UK population using a recent meta-analysis of randomised evidence of statin effects in older people and a new validated CVD model.

methodsThe performance of the CVD microsimulation model, developed using the Cholesterol Treatment Trialists' Collaboration (CTTC) and UK Biobank cohort, was assessed among participants ≥70 years old at (re)surveys in UK Biobank and the Whitehall II studies. The model projected participants' cardiovascular risks, survival, quality-adjusted life years (QALYs) and healthcare costs (2021 UK£) with and without lifetime standard (35%-45% low-density lipoprotein cholesterol reduction) or higher intensity (≥45% reduction) statin therapy. CTTC individual participant data and other meta-analyses informed statins' effects on cardiovascular risks, incident diabetes, myopathy and rhabdomyolysis. Sensitivity of findings to smaller CVD risk reductions and to hypothetical further adverse effects with statins were assessed.

resultsIn categories of men and women ≥70 years old without (15,019) and with (5,103) prior CVD, lifetime use of a standard statin increased QALYs by 0.24-0.70 and a higher intensity statin by a further 0.04-0.13 QALYs per person. Statin therapies were cost-effective with an incremental cost per QALY gained below £3502/QALY for standard and below £11778/QALY for higher intensity therapy and with high probability of being cost-effective. In sensitivity analyses, statins remained cost-effective although with larger uncertainty in cost-effectiveness among older people without prior CVD.

conclusionsBased on current evidence for the effects of statin therapy and modelling analysis, statin therapy improved health outcomes cost-effectively for men and women ≥70 years old.

Indexed as

Cardiovascular DiseasesCost-Benefit AnalysisHydroxymethylglutaryl-CoA Reductase InhibitorsQuality-Adjusted Life YearsAgedAged, 80 and overAge FactorsDrug CostsFemaleHeart Disease Risk FactorsHumansMaleModels, EconomicRisk AssessmentTreatment OutcomeUnited KingdomHydroxymethylglutaryl-CoA Reductase InhibitorsCardiovascular DiseasesComputer SimulationHealth Care Economics and OrganizationsOutcome Assessment, Health Care

Identifiers

PMID39256053
PMCPMC11503164

What OpenQuestion holds

Texttitle and abstract
LicenceCC BY
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.