title: Statin cost effectiveness in primary prevention: a systematic review of the recent cost-effectiveness literature in the United States.
abstract: BACKGROUND
  The literature on the cost-effectiveness of statin drugs in primary prevention of coronary heart disease is complex. The objective of this study is to compare the disparate results of recent cost-effectiveness analyses of statins.
  
  
  RESULTS
  We conducted a systematic review of the literature on statin cost-effectiveness. The four studies that met inclusion criteria reported varying conclusions about the cost-effectiveness of statin treatment, without a clear consensus as to whether statins are cost-effective for primary prevention. However, after accounting for each study's assumptions about statin costs, we found substantial agreement among the studies. Studies that assumed statins to be more expensive found them to be less cost-effective, and vice-versa. Furthermore, treatment of low-risk groups became cost-effective as statins became less expensive.
  
  
  CONCLUSIONS
  Drug price is the primary determinant of statin cost-effectiveness within a given risk group. As more statin drugs become generic, patients at low risk for coronary disease may be treated cost-effectively. Though many factors must be weighed in any medical decision, from a cost-effectiveness perspective, statins may now be considered an appropriate therapy for many patients at low risk for heart disease.
authors: Duke University Medical Center, Medical Residency Office Rm 8254DN, 2301 Erwin Rd, Durham, NC 27710, USA. aaron.mitchell@duke.edu
authors: Aaron P
authors: AP
authors: Mitchell
authors: Ross J
authors: RJ
authors: Simpson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000191:economics* / Q000209:etiology / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000191:economics*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention / Q000191:economics*; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors