title: The large social value resulting from use of statins warrants steps to improve adherence and broaden treatment.
abstract: Statins are considered a clinically important breakthrough for the treatment of cardiovascular disease. However, their social value at the US population level has not previously been studied. From an economic perspective, social value measures the quantity of resources--in monetary terms--that society would be willing to give up in order to retain the survival gains resulting from statin therapy. Using combined population and clinical data, this article calculates statins' social value to consumers, or the value of survival benefits above actual payments for the drug, and to producers, or drug revenues, for the period 1987-2008. National survey data suggest that statin therapy reduced low-density lipoprotein levels by 18.8 percent, which translated into roughly 40,000 fewer deaths, 60,000 fewer hospitalizations for heart attacks, and 22,000 fewer hospitalizations for strokes in 2008. For people starting statin therapy in 1987-2008, consumers captured $947.4 billion (76 percent) of the total social value of the survival gains. Even greater consumer benefits could be achieved in the future if statins were prescribed in full compliance with cholesterol guidelines and patients adhered to prescribed regimens. In addition, statin costs are declining because of patent expirations. Policy makers should consider interventions at the patient and provider levels to encourage both therapy for untreated patients with high cholesterol and greater adherence after therapy is initiated.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA. grabowski@hcp.med.harvard.edu
authors.forename: David C
authors.initials: DC
authors.lastname: Grabowski
authors.forename: Darius N
authors.initials: DN
authors.lastname: Lakdawalla
authors.forename: Dana P
authors.initials: DP
authors.lastname: Goldman
authors.forename: Michael
authors.initials: M
authors.lastname: Eber
authors.forename: Larry Z
authors.initials: LZ
authors.lastname: Liu
authors.forename: Tamer
authors.initials: T
authors.lastname: Abdelgawad
authors.forename: Andreas
authors.initials: A
authors.lastname: Kuznik
authors.forename: Michael E
authors.initials: ME
authors.lastname: Chernew
authors.forename: Tomas
authors.initials: T
authors.lastname: Philipson
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000494:pharmacology / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy*; D055118:Medication Adherence; D009749:Nutrition Surveys; D012945:Social Values; D016019:Survival Analysis; D014481:United States
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors