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Statins Tenuously Cost-Effective for Primary Prevention in Seniors

Statins would prevent MIs, CHD, be cost-effective if no increase in geriatric-specific adverse effects

TUESDAY, April 21, 2015 (HealthDay News) -- For U.S. adults aged 75 to 94 years, primary prevention with statins appears to be cost-effective, but even small increases in geriatric-specific adverse effects could offset the cardiovascular benefit, according to a study published in the April 21 issue of the Annals of Internal Medicine.

Michelle C. Odden, Ph.D., from Oregon State University in Corvallis, and colleagues estimated the population impact and cost-effectiveness of statin therapy in adults aged 75 years and older. Data were included from trial, cohort, and nationally representative sources for U.S. adults aged 75 to 94 years. The intervention modeled was statins for primary prevention based on low-density lipoprotein cholesterol thresholds of 4.91 mmol/L, 4.14 mmol/L, or 3.36 mmol/L; presence of diabetes; or 10-year risk score of at least 7.5 percent.

The researchers found that all adults aged 75 years or older in the National Health and Nutrition Examination Survey had a 7.5 percent or higher 10-year risk score. All primary prevention strategies would prevent myocardial infarctions and coronary heart disease deaths and be cost-effective if statins had no impact of functional limitation or cognitive impairment. Treatment of all 75- to 94-year-old adults would result in eight million additional statin users and could avert 105,000 (4.3 percent) incident myocardial infarctions and 68,000 (2.3 percent) coronary heart disease deaths. The incremental cost per disability-adjusted life-year was projected as $25,200.

"Statins are projected to be cost-effective for primary prevention; however, even a small increase in geriatric-specific adverse effects could offset the cardiovascular benefit," the authors write.

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