Giving Older Seniors a Statin Seems Economical
Using a variety of reasonable assumptions about cholesterol-lowering efficacy, drug costs, and rates of cardiac and cardiovascular events, researchers from Harvard Medical School and two other Boston area institutions estimated the cost-effectiveness of treating patients, ages 75 to 84, with the equivalent of pravastatin 40 mg daily. The researchers selected this statin and dosage as the basis for drug costs because the information about cholesterol-lowering efficacy had been taken from a trial in which patients received pravastatin 40 mg daily.
According to the researchers decision-based analytical model, statin therapy for older seniors who have had a myocardial infarction would cost society $18,800 more for each year of life gained than if they received usual care. This figure is similar to figures for other accepted medical interventions, such as treatment of hypertension in patients 35 to 64 years old.
Previous research has shown that statin therapy reduces the rates of coronary and cerebrovascular events in patients as old as 75 years who have had a myocardial infarction. But whether this therapy also benefits similar patients older than 75 years is not yet known.
Pending the results of randomized, controlled trials of statin therapy for the secondary prevention of myocardial infarction or stroke, the researchers offer their analysis "as a data-driven basis for policy decisions about drug therapy in this large and growing population of patients."
The researchers' findings were published in the May 16 Annals of Internal Medicine.