Lipid-lowering efficacy, safety, and costs of a large-scale therapeutic statin formulary conversion program.
OBJECTIVE
To assess the lipid-lowering efficacy, safety, and costs of a large-scale statin formulary conversion program.


METHODS
Prospective, observational study.


METHODS
Tertiary academic medical center.


METHODS
A total of 980 patients consented to participate; 942 patients completed the study.


METHODS
Patients were converted from their current statin therapy to either cerivastatin 0.4 or 0.8 mg/day, or simvastatin 80 mg/day, using a conversion algorithm.


RESULTS
Efficacy and safety were evaluated at baseline and after 6 weeks of therapy; costs were also measured. Overall attainment of the National Cholesterol Education Program (NCEP) goal for low-density lipoprotein cholesterol (LDL) increased from 64.8% to 74.5% of patients (p<0.001); mean LDL decreased from 115+/-30 mg/dl to 106+/-25 mg/dl (p<0.001). Adverse events occurred in 3% of patients, and included myositis (0.6%) and increased hepatic transaminases (0.1%). Overall costs were reduced by $115/patient treatment-year.


CONCLUSIONS
Statin therapeutic interchange can improve lipid control at reduced costs. The possibility of uncommon but potentially serious adverse effects suggests that these programs require appropriate monitoring.
Taylor
A J
AJ
Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307-5001, USA. allen.taylor@na.amedd.army.mil
Grace
K
K
Swiecki
J
J
Hyatt
R
R
Gibbs
H
H
Sheikh
M
M
O'Malley
P G
PG
Lowenthal
S P
SP
West
M
M
Spain
J
J
Maneval
K
K
Jones
D L
DL
D000368:Aged; D000465:Algorithms; D000924:Anticholesteremic Agents / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D003365:Costs and Cost Analysis; D004305:Dose-Response Relationship, Drug; D005572:Formularies, Hospital as Topic; D006772:Hospitals, Military / Q000191:economics; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011725:Pyridines / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D019821:Simvastatin / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D008055:Lipids; D011725:Pyridines; D019821:Simvastatin; C086276:cerivastatin