Treatment with statins is cost-effective for 48% to 67% of all adults aged 40 years to 75 years, based on the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines, according to a study published online ahead of print July 14 in JAMA.
The guidelines recommend that statins be prescribed for people with a 7.5% or greater risk of heart attack or stroke over a 10-year period.
Lead author Ankur Pandya, PhD, and colleagues performed a cost-effectiveness analysis of the guidelines using a measure known as the quality-adjusted life-year (QALY), which assesses the burden of a disease in terms of both the quality and the quantity of life lived. The researchers found that the 10-year CVD risk threshold of 7.5% or more, which translates to approximately 48% of adults treated with statins, was acceptable in terms of cost-effectiveness ($37,000/QALY). However, lower treatment thresholds of 4.0% or more (61% of adults treated) or 3.0% or more (67% of adults treated) would be optimal for a cost-effectiveness of less than $100,000/QALY or less than $150,000/QALY, respectively. They also found that the optimal treatment threshold was sensitive to patient preferences for taking a pill daily, changes in the price of the statin, and the risk of statin-induced diabetes.