Application of the 1998 Canadian cholesterol guidelines to a military population: health benefits and cost effectiveness of improved cholesterol management.
OBJECTIVE
To determine whether statins are underprescribed in the Canadian military. The cost effectiveness of statin therapy in patients identified by the 1998 Canadian cholesterol interim guidelines was also explored.


METHODS
Charts of 1424 Canadian military personnel (age 45 or older) were reviewed at 11 Canadian bases. Risk factors and cholesterol values were used to identify drug therapy candidates. Cost effectiveness ratios and health benefits in terms of years of life saved for statin therapy were estimated for the candidates using a validated cardiovascular disease life expectancy model.


RESULTS
Of the 1313 personnel not on lipid lowering medication, 172 were identified as drug therapy candidates. An average of 2.89 years of life saved was forecast for the identified personnel, at an average cost of less than 10,000 dollars per year of life saved.


CONCLUSIONS
The health benefits of statin therapy in this population are substantial and the cost effectiveness is acceptable. Statin therapy warrants greater attention as a preventive strategy for coronary artery disease.
Spaans
Johanna N
JN
Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Canada. johannaspaans@hotmail.com
Coyle
Douglas
D
Fodor
George
G
Nair
Rama
R
Vaillancourt
Régis
R
Grover
Steven A
SA
Coupal
Louis
L
D002170:Canada; D003324:Coronary Artery Disease / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors