When sweeping new advice on preventing heart attacks and strokes came out last November, it wasn’t clear how many more Americans should be taking daily statin pills to lower their risk.
A new analysis provides an answer: a whole lot. Nearly 13 million more, to be precise.
If the guidelines were followed to the letter, about half of all Americans over 40 would be on cholesterol-lowering statins — more than double the current level.
Even more striking, the new recommendations would make prescription of the drugs almost universal among older men. “What was personally most surprising to me, is that it turns out the difference between the old and new guidelines is very small in younger adults — 40 to 59,” says Duke University biostatistician Michael Pencina, lead author of the study.
“The vast majority of those affected by the new guidelines are between 60 and 75,” he says. “So much so that 87 percent of men 60 to 75 and 54 percent of women [in that age range] should be on statins.”
The great majority of Americans newly recommended for statin treatment have no known heart disease, Pencina and his colleagues say.
The analysis was published online Wednesday by the New England Journal of Medicine.
Statin drugs are pretty cheap these days. Most are generics. Common doses of atorvastatin, the generic form of Lipitor, can be had for 50 cents a day. Older statins cost even less. Still, the number of potential patients is so huge that the recommended expansion in treatment has major cost implications.
If all those newly recommended for treatment got the drugs, the expansion would cost from $2 billion to $6.6 billion a year more than the price tag under the old guidelines, which is $7.8 billion to $22.4 billion depending on cost assumptions for a year’s worth of the drugs .