Table 1

Statin treatment effects and statin treatment costs

ItemValueSource
LDL cholesterol reductions with statin therapy:

  • With standard statin therapy (eg, atorvastatin 20 mg/day, rosuvastatin 5–10 mg/day or simvastatin 40–80 mg/day)

37%–43%; 43% usedMeta-analysis of randomised controlled trials12

  • With higher intensity statin therapy (eg, atorvastatin 40–80 mg/day, rosuvastatin 20–80 mg/day)

48%–58%; 55% usedMeta-analysis of randomised controlled trials12
Effects of statin therapy on cardiovascular events per 1 mmol/L reduction in LDL cholesterol, Risk Ratio (RR) (95% CI)Cholesterol Treatment Trialists’ Collaboration individual participant data meta-analysis2

  • Myocardial infarction (MI)

RR 0.76 (0.73 to 0.79)

  • Stroke

RR 0.84 (0.80 to 0.89)

  • Coronary revascularisation (CRV)

RR 0.75 (0.73 to 0.78)

  • Cardiovascular death

RR 0.88 (0.85 to 0.91)
Adverse effects of statin therapy on:
Incident diabetes, OR (95% CI)

  • With standard statin therapy compared with no statin treatment

OR 1.09 (1.02 to 1.17)Meta-analyses of randomised controlled trials13

  • With higher intensity statin therapy compared with standard statin therapy

OR 1.12 (1.04 to 1.22)Meta-analyses of randomised controlled trials14
Myopathy

  • Excess rate per 100 000 treated with statin therapy pre-year (95% CI)

11 (4 to 27)Overview of cohort studies15

  • Occurrence of myopathy is associated with reduction in QoL over 30 days recovery period. Statin treatment is stopped.

0.017 QALY reduction in year of eventModelling study.16
Rhabdomyolysis

  • Excess rate per 100 000 treated with statin therapy per year (95% CI)

3.4 (1.6 to 6.5)Overview of cohort studies15

  • Case fatality

10%Overview of cohort studies15

  • Reduction in QoL

50% over 7.5 days hospital admission and by 20% for further 30 days recoveryModelling study.16
Statin therapy costs

  • Standard statin therapy (eg, atorvastatin 20 mg/day, rosuvastatin 5–10 mg/day or simvastatin 40–80 mg/day)

£14.09 to £19.57 per year; £14.35 used in base-caseNHS Drug tariff, December 202117

  • Higher intensity statin therapy (eg, atorvastatin 40–80 mg/day, rosuvastatin 20–40 mg/day)

£15.91 to £27.91 per year; £21.91 used in base-caseNHS Drug tariff, December 202117
Statin initiation and monitoring healthcare costs

  • in year of initiation (doctor and nurse consultations; tests of blood lipids, HbA1c, thyroid function)

£54.65Unit costs for Health and Social Care18; NHS reference costs19

  • in subsequent years: a nurse consultation and a blood lipids test (for people with history of CVD)

£12.05Unit costs for Health and Social Care18; NHS reference costs19

  • CVD, cardiovascular disease; HbA1c, hemoglobin A1C ; LDL, low-density lipoprotein; NHS, National Health Service England; NICE, National Institute for Health and Care Excellence; OR, odds ratio; QoL, quality of life; RR, relative risk.