title: Cost efficiency and formulary considerations for statin therapy.
abstract: Extensive epidemiologic evidence and reports issued by the National Cholesterol Education Program have repeatedly identified low-density lipoprotein cholesterol (LDL-C) as the primary target in reducing the primary and secondary risk of coronary events. With recent evidence supporting a more aggressive approach using higher potency statins, and a lower threshold for initiating drug therapy for high-risk patients, providers and administrators in managed care are charged with finding the most effective and cost-effective means of attaining these goals. Changes in the market, such as newer high-potency statins and statin combinations available at lower cost and expiration of patents on widely accepted brand drugs, have provided practitioners with the ability to reduce LDL-C at lower costs than ever. The cost-efficiency analysis presented here finds that, for low-to-moderate reduction (<40%), generic lovastatin and simvastatin provide the lowest cost per 1% LDL-C reduction. Similarly, for reduction greater than 40%, branded rosuvastatin and ezetimibe/simvastatin have the lowest cost per 1% reduction.
authors.affiliation: The Regence Group, 1211 W Myrtle, #110, Boise, ID 83701, USA. tkillilea.id@regence.com
authors.forename: Terrance
authors.initials: T
authors.lastname: Killilea
authors.forename: Lori
authors.initials: L
authors.lastname: Funk
mesh_terms: D008078:Cholesterol, LDL / Q000187:drug effects*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D019317:Evidence-Based Medicine; D005569:Formularies as Topic; D017048:Health Care Costs; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D016896:Treatment Outcome; D014481:United States
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors