Health-economic evaluation of statins versus lifestyle changes for cardiovascular disease prevention

Afschin Gandjour

PLOS ONE, 2025, vol. 20, issue 9, 1-13

Abstract: Introduction: The German Federal Ministry of Health aims to improve cardiovascular health by expanding statin eligibility. However, the shift in funding from lifestyle-based preventive programs to statins has raised concerns that existing prevention efforts could be undermined. This study assessed the cost-effectiveness of statins compared with lifestyle interventions for the prevention of cardiovascular disease (CVD) in Germany under constrained healthcare budgets. Methods: A cost-effectiveness analysis was conducted using secondary data. Effectiveness data for statins were drawn from meta-analyses and systematic reviews, showing a 26% reduction in major cardiovascular events. Lifestyle intervention data were derived from the US Preventive Services Task Force (2020), reporting a relative risk of 0.80 for CVD events. A z-score test compared the effectiveness, while a Bayesian analysis assessed the probability of statins being more effective. Costs were analyzed from the perspective of German statutory health insurance (SHI) enrollees, including copayments and treatment monitoring expenses. Results: The z-score of −1.26 (p = 0.207) indicated no statistically significant difference in the effectiveness of statins compared to lifestyle interventions. However, Bayesian analysis estimated an 89.7% probability that statins are more effective. Statins were generally cheaper, especially when preventive courses are repeated annually. Conclusions: Statins likely offer higher cost-effectiveness than lifestyle changes, though the difference in benefits is not statistically significant. Concerns about reallocating funds from lifestyle programs to statins are somewhat mitigated by these findings.

Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0331176 (text/html)
https://journals.plos.org/plosone/article/file?id= ... 31176&type=printable (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0331176

DOI: 10.1371/journal.pone.0331176

Access Statistics for this article

More articles in PLOS ONE from Public Library of Science
Bibliographic data for series maintained by plosone ().