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Published on: November 10, 2017
Pharmacoeconomic considerations with statin therapy
Katie M Speidel1, Daniel E Hilleman
1The Cardiac Center of Creighton University, 3006 Webster Street, Omaha, NE 68131-2044, USA. katie.speidel@cardiac.creighton.edu
Insights
Statins effectively reduce cardiovascular events and mortality, proving cost-effective. Current research emphasizes optimizing statin therapy with high-intensity dosing for greater low-density lipoprotein cholesterol reduction and patient benefit.
Area of Science:
- Cardiovascular Medicine
- Pharmacoeconomics
- Clinical Pharmacology
Background:
- Statins are proven to reduce morbidity and mortality in diverse patient populations.
- Previous economic evaluations confirmed the cost-effectiveness of statins based on mortality trials.
- Placebo-controlled trials offer limited guidance for current statin selection decisions.
Purpose of the Study:
- To review the evolving landscape of statin therapy optimization.
- To highlight the need for economic analyses of comparative statin studies.
- To inform drug therapy selection and formulary decisions.
Main Methods:
- Review of recent clinical trials comparing different statin intensities.
- Analysis of findings regarding low-density lipoprotein cholesterol reduction efficacy.
- Identification of the gap in published economic evaluations for comparative studies.
Main Results:
- More intensive statin therapy, with higher doses, yields greater low-density lipoprotein cholesterol reduction and clinical benefit.
- Statins demonstrating superior efficacy in lowering low-density lipoprotein cholesterol are preferred.
- Economic analyses of these comparative studies are currently lacking.
Conclusions:
- Optimizing statin therapy requires considering high-intensity regimens for enhanced patient outcomes.
- Comparative efficacy in low-density lipoprotein cholesterol reduction is a key factor in selecting statins.
- Urgent need for pharmacoeconomic studies to guide evidence-based statin selection and formulary placement.
Abstract:
Statins have been shown to reduce morbidity and mortality in patients with and without coronary heart disease, and in patients with elevated and normal or average cholesterol levels. Economic evaluations of these mortality trials have demonstrated statins to be cost-effective. As these trials were placebo comparisons, their results are now of limited use in guiding the drug therapy selection process. The more relevant questions today are focused on ways of optimising statin therapy. More recent studies have found that more intensive statin therapy, using high doses of these agents that produce substantially greater reductions in low-density lipoprotein cholesterol, are associated with greater benefit than less intensive statin therapy. These trials suggest that statins with greater efficacy in reducing low-density lipoprotein cholesterol, would be preferred over less effective statins. So far, economic analyses of these comparative studies have not been published. These economic studies are needed to support formulary and drug therapy selection decisions regarding statins.
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