E. Thorvik et al., COST-EFFECTIVENESS OF CHOLESTEROL-LOWERING DRUGS - A REVIEW OF THE EVIDENCE, Wiener Klinische Wochenschrift, 108(8), 1996, pp. 234-243
Four studies of the cost per life year saved through lipid lowering wi
th lovastatin or simvastatin showed considerable variation in the resu
lts. For example, the cost per life year saved on administration of si
mvastatin 20 mg/day for primary prevention in men 42 years old at the
start of therapy and with an initial cholesterol level of 8 mmol/L, wa
s 19,000 1994-US dollars according to one study, and 55,000 according
to another. Both when the differences were due to different cost estim
ates and when they were due to different estimates of the number of li
fe years saved, plausible explanations for the discrepancies between t
he cost-effectiveness ratios were generally found. The cost per life y
ear saved through primary prevention was about three times greater amo
ng women than men at age 40, twice greater at age 60, and 1.3 times gr
eater at age 70. The accordance between the studies was not good regar
ding how cost per life year saved varies with age at the start of drug
therapy. According to one study, the cost per life year saved for sec
ondary prevention is generally low. We also compared the estimates for
statins with estimates for several other life-extending health interv
entions. Given current guidelines for the prescription of cholesterol-
lowering drugs, primary prevention with statins seems generally to be
one of the less cost-effective life-extending health interventions, es
pecially for women. The cost-effectiveness of statins is likely to bec
ome more favorable. though, when the patents on these drugs expire.