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.

Association of Copayment with Likelihood and Level of Adherence in New Users of Statins: A Retrospective Cohort Study

“…For the NonService-Connected, the incurred cost for their statins is equal to that of any other medication provided by the VHA. This similarity of cost would result in improved consumption of 18,27,28 We did not add additional days at the end of fill for early refills. A possibility remains that patients who were late at one point in the year filled early later that year and thus "repaired" their MPR.…”

Association of Polypharmacy and Statin New-User Adherence in a Veterans Health Administration Population

“…27 Moreover, statins are well studied molecules, where the benefits of long-term consumption and elevated adherence goals are understood. 28,29 This study has limitations The VHA provides a greater level of integrated care from clinicians and pharmacies than commonly afforded to nonveterans, with more opportunities to reinforce the need for medication adherence through medication reconciliation, use of an integrated electronic health care record, and active pharmacist interventions. However, these measures vary depending on the Veterans Integrated System Network of interest.…”

Reducing residual risk: modern pharmacochemistry meets old-fashioned lifestyle and adherence improvement

“…The polypill approach has received the attention of the Wellcome Trust and World Health Organization, and is endorsed by the World Heart Federation and other authorities concerned about the inordinate burden of CHD and human cost [Grabowski et al 2012;. Use of polypills has immense potential, few side effects, supportive evidence is strong, and comparable alternatives are sparse.…”