Lifetime effects and cost-effectiveness of standard and higher-intensity statin therapy across population categories in the UK : a microsimulation modelling study
© 2024 The Authors..
Background: Cardiovascular disease incidence and mortality have declined across developed economies and granular up-to-date cost-effectiveness evidence is required for treatments targeting large populations. To assess the health benefits and cost-effectiveness of standard and higher intensity statin therapy in the contemporary UK population 40-70 years old.
Methods: A cardiovascular disease microsimulation model, developed using the Cholesterol Treatment Trialists' Collaboration data (117,896 participants; 5 years follow-up), and calibrated in the UK Biobank cohort (501,854 participants; 9 years follow-up), projected risks of myocardial infarction, stroke, coronary revascularization, diabetes, cancer and vascular and nonvascular death for all UK Biobank participants without and with statin treatment. Meta-analyses of trials and cohort studies informed statins' relative effects on cardiovascular events, incident diabetes, myopathy and rhabdomyolysis. UK healthcare perspective was taken (2020/2021 UK£) with costs per 28 tablets of £1.10 for standard (35%-45% LDL cholesterol (LDL-C) reduction) and £1.68 for higher intensity (≥45% LDL-C reduction) generic statin.
Findings: Across categories by sex, age, LDL-C, and cardiovascular disease history/10-year cardiovascular risk, lifetime standard statin increased survival by 0.28-1.85 years (0.20-1.09 quality-adjusted life years (QALYs)), and higher intensity statin by further 0.06-0.40 years (0.03-0.20 QALYs) per person. Standard statin was cost-effective across all categories with incremental cost per QALY from £280 to £8530, with higher intensity statin cost-effective at higher cardiovascular risks and higher LDL-C levels. Stopping statin early reduced benefits and was not cost-effective.
Interpretation: Lifetime low-cost statin therapy is cost-effective across all 40-70 years old in UK. Strengthening and widening statin treatment could cost-effectively improve population health.
Funding: UK NIHR Health Technology Assessment Programme (17/140/02).
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:40 |
|---|---|
| Enthalten in: |
The Lancet regional health. Europe - 40(2024) vom: 28. März, Seite 100887 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Mihaylova, Borislava [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cardiovascular diseases |
|---|
| Anmerkungen: |
Date Revised 30.03.2024 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
|---|
| doi: |
10.1016/j.lanepe.2024.100887 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM370392590 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM370392590 | ||
| 003 | DE-627 | ||
| 005 | 20240331002217.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 240330s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.lanepe.2024.100887 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1357.xml |
| 035 | |a (DE-627)NLM370392590 | ||
| 035 | |a (NLM)38549731 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Mihaylova, Borislava |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Lifetime effects and cost-effectiveness of standard and higher-intensity statin therapy across population categories in the UK |b a microsimulation modelling study |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 30.03.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a © 2024 The Authors. | ||
| 520 | |a Background: Cardiovascular disease incidence and mortality have declined across developed economies and granular up-to-date cost-effectiveness evidence is required for treatments targeting large populations. To assess the health benefits and cost-effectiveness of standard and higher intensity statin therapy in the contemporary UK population 40-70 years old | ||
| 520 | |a Methods: A cardiovascular disease microsimulation model, developed using the Cholesterol Treatment Trialists' Collaboration data (117,896 participants; 5 years follow-up), and calibrated in the UK Biobank cohort (501,854 participants; 9 years follow-up), projected risks of myocardial infarction, stroke, coronary revascularization, diabetes, cancer and vascular and nonvascular death for all UK Biobank participants without and with statin treatment. Meta-analyses of trials and cohort studies informed statins' relative effects on cardiovascular events, incident diabetes, myopathy and rhabdomyolysis. UK healthcare perspective was taken (2020/2021 UK£) with costs per 28 tablets of £1.10 for standard (35%-45% LDL cholesterol (LDL-C) reduction) and £1.68 for higher intensity (≥45% LDL-C reduction) generic statin | ||
| 520 | |a Findings: Across categories by sex, age, LDL-C, and cardiovascular disease history/10-year cardiovascular risk, lifetime standard statin increased survival by 0.28-1.85 years (0.20-1.09 quality-adjusted life years (QALYs)), and higher intensity statin by further 0.06-0.40 years (0.03-0.20 QALYs) per person. Standard statin was cost-effective across all categories with incremental cost per QALY from £280 to £8530, with higher intensity statin cost-effective at higher cardiovascular risks and higher LDL-C levels. Stopping statin early reduced benefits and was not cost-effective | ||
| 520 | |a Interpretation: Lifetime low-cost statin therapy is cost-effective across all 40-70 years old in UK. Strengthening and widening statin treatment could cost-effectively improve population health | ||
| 520 | |a Funding: UK NIHR Health Technology Assessment Programme (17/140/02) | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Cardiovascular diseases | |
| 650 | 4 | |a Cost-effectiveness | |
| 650 | 4 | |a Health care costs | |
| 650 | 4 | |a Microsimulation model | |
| 650 | 4 | |a Quality-adjusted life years | |
| 650 | 4 | |a Statin | |
| 700 | 1 | |a Wu, Runguo |e verfasserin |4 aut | |
| 700 | 1 | |a Zhou, Junwen |e verfasserin |4 aut | |
| 700 | 1 | |a Williams, Claire |e verfasserin |4 aut | |
| 700 | 1 | |a Schlackow, Iryna |e verfasserin |4 aut | |
| 700 | 1 | |a Emberson, Jonathan |e verfasserin |4 aut | |
| 700 | 1 | |a Reith, Christina |e verfasserin |4 aut | |
| 700 | 1 | |a Keech, Anthony |e verfasserin |4 aut | |
| 700 | 1 | |a Robson, John |e verfasserin |4 aut | |
| 700 | 1 | |a Parnell, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Armitage, Jane |e verfasserin |4 aut | |
| 700 | 1 | |a Gray, Alastair |e verfasserin |4 aut | |
| 700 | 1 | |a Simes, John |e verfasserin |4 aut | |
| 700 | 1 | |a Baigent, Colin |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The Lancet regional health. Europe |d 2021 |g 40(2024) vom: 28. März, Seite 100887 |w (DE-627)NLM323979734 |x 2666-7762 |7 nnns |
| 773 | 1 | 8 | |g volume:40 |g year:2024 |g day:28 |g month:03 |g pages:100887 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.lanepe.2024.100887 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 40 |j 2024 |b 28 |c 03 |h 100887 | ||