title: [Can we afford good cholesterol lowering therapy? Budgeting of statin costs versus medical needs in the county of Stockholm].
abstract: Increasing drug costs are a concern in Sweden. The costs for statin treatment are considerable, and among those increasing most rapidly (by 30-35% per year). Our survey of eligibility for statin treatment in Stockholm according to current Swedish recommendations (i.e. patients < 75 years with elevated cholesterol and manifest atherosclerotic disease, hereditary dyslipidemia, and diabetes) indicates marked undertreatment. The cost for statins in Stockholm 2000 was SEK 175 M (144 M for patients < 75 years). The projected cost, if current recommendations were to be fully implemented, is SEK 450 M for the target group and > 100 M extra for patients > 75 years and/or high cardiovascular risk. We propose that individual risk assessments should replace crude patient group recommendations to obtain reasonable "numbers needed to treat", i.e. to optimize the expenditure on statins and cost-effectiveness of the therapy. Prioritization of drug expenditures (within and between patient categories) must be debated, and medical needs must be made clear to those who determine the medical budget.
authors.affiliation: Huddinge Universitetssjukhus, Stockholms läns landsting, ledamot av LAKSAKs expertgrupp för hjärt-kärlsjukdomar i Stockholms läns landsting.
authors.forename: B
authors.initials: B
authors.lastname: Wettermark
authors.forename: P
authors.initials: P
authors.lastname: Hjemdahl
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000191:economics*; D002017:Budgets; D003327:Coronary Disease / Q000188:drug therapy / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000517:prevention & control; D016527:Drug Costs; D006292:Health Priorities / Q000191:economics; D006301:Health Services Needs and Demand / Q000191:economics*; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy / Q000517:prevention & control; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011322:Primary Prevention / Q000191:economics; D012307:Risk Factors; D013548:Sweden
chemical_list: D000924:Anticholesteremic Agents
vernacular_title: Har vi råd med en bra kolesterolsänkande behandling? Budgetunderlag för behovsbaserade statinkostnader i Stockholms län.