BMJ 1996;313:1143 (2 November)

Letters

Full treatment of the costs and benefits is needed

EDITOR,--P D P Pharoah and W Hollingworth have produced an interesting article that is of little benefit to the debate on the health economics of lowering lipid concentrations.1 The life table approach suffers from the same deficiency as we2 have pointed out for the Sheffield risk factor table.3 Megnien et al have shown that the risk table does not differ significantly from the currently accepted guidelines once correct assumptions are made.4

The major deficiency in the life table approach is simple--death is cheap for the health service. The principal saving for lipid lowering agents is in procedures not needed and hospital beds not required. A full cost analysis has already been published for the Scandinavian simvastatin survival study for the United States and shows reductions in cardiovascular procedures of 31% and hospital stays of 34%.5 This leads to a net cost of the drug of 28 cents (19p) a day. . . . [Full text of this article]


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Relevant Article

Cost effectiveness of lowering cholesterol concentration with statins in patients with and without pre-existing coronary heart disease: life table method applied to health authority population
P D P Pharoah and W Hollingworth
BMJ 1996 312: 1443-1448. [Abstract] [Full Text]

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