Pharmacoeconomic considerations with statin therapy

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.