Determining Cost-Saving Risk Thresholds for Statin Use

Background: Statins are widely prescribed to reduce cholesterol levels and decrease the risk of cardiovascular diseases. This study aims to determine cost-saving risk thresholds for statin use in Germany to inform better prescription practices and healthcare policies. Methods: A decision-analytic approach was employed, using secondary data to compare statin use with no statin use from the perspective of German sickness fund insurees. The analysis focused on cost savings from avoided cardiovascular (CV) events, translating these avoided events into net savings after accounting for treatment costs and potential side effects. The study considered the German adult population insured by sickness funds and used a lifetime horizon for the analysis. Results: The maximum number needed to treat (NNT) to achieve cost savings over 10 years was found to be 40, leading to a minimum risk threshold for savings of 9.8%. It was estimated that approximately 22% of the adult population in Germany has a 10-year CV risk of 9.8%, potentially avoiding between 307,049 and 705,537 CV events over 10 years, with net population savings of approximately 18 billion euros. Conclusions: The current official threshold for statin prescription in Germany, set at a 20% 10-year risk, is too stringent. Lowering the threshold to 9.8% could significantly increase the number of patients benefiting from statin therapy, reducing CV events and generating substantial cost savings. These findings suggest that adjustments to prescription guidelines could improve cardiovascular outcomes and economic efficiency within the German healthcare system.