14 Jul Putting More People On Statins Would Be Cost Effective and Improve Heart Health
MedicalResearch.com Interview with:
Dr. Ankur Pandya Ph.D.
Assistant Professor of Health Decision Science
Department of Health Policy and Management
Harvard T.H. Chan School of Public Health
Boston, MA
Medical Research: What is the background for this study? What are the main findings?
Dr. Pandya: The American College of Cardiology and the American Heart Association (ACC-AHA) cholesterol treatment guidelines were controversial when first released in November 2013, with some concerns that healthy adults would be over-treated with statins.
We found that the current 10-year ASCVD risk threshold (≥7.5%) used in the ACC-AHA cholesterol treatment guidelines has an acceptable cost-effectiveness profile (incremental cost-effectiveness ratio of $37,000/QALY), but more lenient ASCVD thresholds would be optimal using cost-effectiveness thresholds of $100,000/QALY (≥4.0%) or $150,000/QALY (≥3.0%).
Medical Research: What should clinicians and patients take away from your report?
Dr. Pandya: It would be cost effective to treat 48-67% of all adults aged 40-75 in the United States with statins.
We found that our results were sensitive to patient preferences for taking a pill daily. Specifically, most patients don’t mind taking a pill daily; for these types of individuals, an ASCVD threshold as low as ≥3.0% (i.e., 67% of adults treated) was cost-effective. But for patients that associate substantial disutility with act of taking a pill daily (disutility of -0.009), the optimal ASCVD threshold could be as high as ≥15.0% (i.e., 39% of adults treated).
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Pandya: Given the importance of patient preference on the optimal treatment threshold, it would very useful to see more studies that further quantify the quality-of-life impacts of cardiovascular disease prevention efforts (such as a taking a pill daily, other forms of medical treatment, behaviors such as diet and exercise, etc.).
Citation:
Ankur Pandya, Stephen Sy, Sylvia Cho, Milton C. Weinstein, Thomas A. Gaziano. Cost-effectiveness of 10-Year Risk Thresholds for Initiation of Statin Therapy for Primary Prevention of Cardiovascular Disease. JAMA, 2015; 314 (2): 142 DOI: 10.1001/jama.2015.6822
Dr. Ankur Pandya Ph.D. (2015). Putting More People On Statins Would Be Cost Effective and Improve Heart Health
Last Updated on July 14, 2015 by Marie Benz MD FAAD