Statin Rx Cost-Effective Based on C-Reactive Proteins

Using data from the landmark JUPITER trial (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin), researchers told colleagues at the American College of Cardiology meeting that the trial "provides compelling evidence that more adults could benefit from statin treatment by preventing vascular adverse events than are presently included in the National Cholesterol Education Program Adult Treatment Panel." 

That's because the panel does not address C-reactive protein status as a primary risk factor, said Julia F. Slejko, BA, a PhD candidate at the University of Colorado School of Pharmacy, Denver.

"If the NCEP guidelines are expanded to address C-reactive protein, it is estimated that six million to ten million adults would be new statin users, in addition to the 6.5 million adults who are currently statin users," she said at her poster presentation.

Slejko and colleagues set out to determine if treatment would be cost-effective from the societal perspective, using the oft-cited cutoff of $50,000 per quality adjusted life-year.

The difference between this study and others is that stroke prevention was added to coronary heart disease prevention for the purposes of modeling.

The researchers identified a hypothetical 57-year-old individual who would require lifetime statin therapy as the model for the Markov simulation.

Slejko ran the simulation 10,000 times and determined that in 92% of the cases, the cost of a quality adjusted life-year would be less than $50,000. She said the incremental cost-effectiveness ratio in her model would be $40,457.

"This research suggests that statin prevention in those with elevated C-reactive protein is cost-effective," Slejko said. "This may support the hypothesis that expanding the NCEP guidelines would also be cost-effective."

On the other hand, Slejko cautioned that if the guidelines were updated to include C-reactive protein, more than half the new patients would be Medicare beneficiaries.

Slejko J, et al "Statin therapy is cost-effective for vascular event prevention in adults with elevated C-reactive protein: Implications of JUPITER" ACC 2010; Abstract 1030-172.