BACKGROUND: Due to increasing pressure to save money in the health care sector economical evaluations become more and more important. The following article deals with cost-effectiveness analyses regarding lipid-lowering therapy. Results are discussed in the light of methodological issues. COMPARISON OF EFFECTIVENESS: The choice of life years gained as effectiveness parameter facilitates the comparison of different therapies. Non-pharmacological therapies were able to achieve a reduction of risk factors, but a mortality reduction has not been proven so far. COST-EFFECTIVENESS OF STATINS: Own analyses from the perspective of the social insurance demonstrate that statins are cost-effective in secondary prevention of coronary heart disease (CHD). This confirms results from the viewpoint of the statutory health insurance under additional consideration of interaction between the various sectors of the social insurance in Germany. In primary prevention the cost-effectiveness is strongly related to the initial CHD risk. For which risk groups the therapy with statins is both effective and efficient depends on the underlying assumptions. Overall accepted threshold values for cost-effective therapies could be reached at a yearly risk of coronary heart disease of about 1.5%. CONCLUSION: The results should be considered by decision makers in the evaluation of statin therapy.
BACKGROUND: Due to increasing pressure to save money in the health care sector economical evaluations become more and more important. The following article deals with cost-effectiveness analyses regarding lipid-lowering therapy. Results are discussed in the light of methodological issues. COMPARISON OF EFFECTIVENESS: The choice of life years gained as effectiveness parameter facilitates the comparison of different therapies. Non-pharmacological therapies were able to achieve a reduction of risk factors, but a mortality reduction has not been proven so far. COST-EFFECTIVENESS OF STATINS: Own analyses from the perspective of the social insurance demonstrate that statins are cost-effective in secondary prevention of coronary heart disease (CHD). This confirms results from the viewpoint of the statutory health insurance under additional consideration of interaction between the various sectors of the social insurance in Germany. In primary prevention the cost-effectiveness is strongly related to the initial CHD risk. For which risk groups the therapy with statins is both effective and efficient depends on the underlying assumptions. Overall accepted threshold values for cost-effective therapies could be reached at a yearly risk of coronary heart disease of about 1.5%. CONCLUSION: The results should be considered by decision makers in the evaluation of statin therapy.