Forecasting Cholesterol Management-End of the Statin Gold Rush?

Initiation of Statins After Hospitalization for Coronary Heart Disease

“…In addition, generic forms of lovastatin became available in the United States in 2002, and in the same year the NCEP guideline on cholesterol control was updated to recommend more aggressive LDL-C lowering among CHD patients. 8,29 Both of these factors might have contributed to the increased statin use in 2002 and more notably in 2003. Additionally, the magnitude of increased statin use in year 2003 was much greater in the subsample with available copayment information, which might be explained by higher homogeneity of the subsample.…”

Tough Questions About the Value of Statin Therapy for Primary Prevention: Did JUPITER Miss the Moon?

“…1,2 Spending money to save money seemed like a reasonable strategy in lowering serum lipids in primary prevention of adverse cardiovascular outcomes, particularly when pravastatin and simvastatin became available by generic name in April and June 2006, respectively, soon thereafter permitting the treatment of several patients for the same drug cost as treating 1 patient with either brand pravastatin (Pravachol) or brand simvastatin (Zocor). 3 Nevertheless, it has long been recognized that the small effect sizes associated with avoidance of adverse cardiovascular outcomes make the use of statins expensive even in secondary prevention, up to $1.1 million in drug cost in 2004 dollars to prevent 1 nonfatal stroke. 4 In an assessment of the cost-effectiveness of primary prevention, Pletcher et al (2009) used Markov modeling to estimate the economic and clinical effects of bringing all adults in the United States into compliance with Adult Treatment Panel III (ATP III) guidelines, finding that 11.1 million adults without coronary heart disease (CHD) would undergo newly initiated (9.7 million) or intensified (1.4 million) statin treatment.…”