Statins in the prevention of cardiovascular disease and deaths
Statins lower blood cholesterol and are used to prevent cardiovascular disease. The efficacy of statins in people with low or moderate risk of cardiovascular disease is the subject of controversy. This report looks at different risk groups to find out how effective, safe and cost-efficient preventive statin treatment is compared with no treatment or only making a lifestyle change.
The 37 medical studies evaluated showed that preventive statin treatment was effective under study conditions and caused few side effects. In isolated cases, liver or kidney dysfunction occurred. Under real-life conditions, there was only limited evidence proving the efficacy and safety of preventive statin treatment.
A cost-benefit analysis showed that statin therapy was more cost-effective in people at higher risk, in younger people and in women. Statin therapy was less cost-effective in people at lower risk, as well as in older people and in men. If all people at low to very high risk are treated, the costs in Switzerland amount to CHF 934 million. If treatment is limited to people between the ages of 60 and 75 who are at high risk of cardiovascular disease, the costs fall to CHF 4 million.
The report concludes that statins can prevent incidents such as heart attacks at strokes in patients without cardiovascular disease at a reasonable cost and with only isolated side effects. However, this observation only applies under study conditions. Adherence to preventive therapies is lower in everyday life than in studies. As there is no current data on the use of statins for the prevention of cardiovascular disease in Switzerland, the cost savings achieved by restricting the reimbursement of statin therapies remain unclear.
Further information
Federal Office of Public Health FOPH
Health Technology Assessment Section
Schwarzenburgstrasse 157
Switzerland - 3003 Bern