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Cost-effectiveness of different statin regimens in people at different levels of vascular risk using data from large statin trials

Dates: 2008-2015
Funding: British Heart Foundation (BHF), HERC
Collaborators: Clinical Trial Service Unit (CTSU), University of Oxford
Further Information: Boby Mihaylova

Cholesterol lowering statin therapy reduces heart attacks and strokes, saves lives, and is considered good value for people at high risk. In our work on the Heart Protection Study we showed that lifelong treatment of people at much lower cardiovascular risk than 2% per annum recommended for treatment at the time may still be cost-effective (see In this study we use data from 27 large statin trials, from the Cholesterol Treatment Trialists' Collaboration (CTT), to produce evidence about the effectiveness and cost-effectiveness of statin regimens for people at different risk of cardiovascular disease. We reported clear evidence for reduction in cardiovascular risk in people at relatively low-risk of cardiovascular disease with LDL-cholesterol lowering with statins (Lancet 2012, 380:581-90). These results have had substantial impact on widening recommendations for the use of statins to people at much lower risk than previously recommended.

Work is underway at present to evaluate the lifetime cost-effectiveness of LDL-cholesterol reduction with statin regimen of different intensity for people at different cardiovascular disease risk.


Cholesterol Treatment Trialists’ (CTT) Collaboration (Writing Committee),, Fulcher, J, O'Connell, R, Voysey, M, Emberson, J, Blackwell, L, Mihaylova, B, Simes, J, Collins, R, Kirby, A, Colhoun, H, Braunwald, E, La Rosa, J, Pedersen, T, Tonkin, A, Davis, B, Sleight, P, Franzosi, M, Baigent, C, and Keech, A (2015). Efficacy and safety of LDL-lowering therapy among men and women: meta-analysis of individual data from 174 000 participants in 27 randomised trials Lancet( doi:10.1016/S0140-6736(14)61368-4).

Cholesterol Treatment Trialists’ (CTT) collaborators (Writing committee: Mihaylova, B, Emberson, J, Blackwell, L, Keech, A, Simes, J, Barnes, EH, Voysey, M, Gray, A, Collins, R, and Baigent, C) (2012). The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet, 380(9841):581-90.