The clinical and economic value of lovastatin in the primary prevention of cardiovascular disease

HMGCoA-inhibitors (statins) lower plasma cholesterol through interference with the rate-limiting enzyme in the endogenous synthesis process. Since their introduction in the early 90’s, the clinical attitude towards cardiovascular (cv) risk reduction has evolved from the attention to single risk fact...

Full description

Bibliographic Details
Main Authors: Lorenzo Pradelli, Orietta Zaniolo
Format: Article
Language:English
Published: SEEd Medical Publishers 2006-09-01
Series:Farmeconomia: Health Economics and Therapeutic Pathways
Subjects:
Online Access:https://journals.seedmedicalpublishers.com/index.php/FE/article/view/261
_version_ 1818324210889523200
author Lorenzo Pradelli
Orietta Zaniolo
author_facet Lorenzo Pradelli
Orietta Zaniolo
author_sort Lorenzo Pradelli
collection DOAJ
description HMGCoA-inhibitors (statins) lower plasma cholesterol through interference with the rate-limiting enzyme in the endogenous synthesis process. Since their introduction in the early 90’s, the clinical attitude towards cardiovascular (cv) risk reduction has evolved from the attention to single risk factors to a more comprehensive global risk evaluation, and thus the indications of statins have broadened from the secondary prevention in hypercholesterolemic patients to include primary prevention in mildly and moderately hypercholesterolemic, or even normocholesterolemic patients, provided their global cv risk is considered high (typically, an estimated major cv event probability greater than 20%). Italian drug utilization data show that a small proportion of patients who could benefit from statins do actually receive them, contributing to the persistence of the clinical and economical burden of cv disease, the leading cause of mortality; since statins have proved effective, and cost-effective, in cv prevention, a more widespread use appears desirable, but requires high investments in pharmaceutical costs. This article defines a clinical profile of lovastatin, a statin with a solid efficacy and safety record only recently introduced into the Italian market despite it has been the first to become clinically available abroad. Among available statin formulations appropriate for target cholesterol reductions up to 30%, which apply to a significant proportion of statin therapy candidates, lovastatin 20 mg is marketed at the lowest price. Although the individual response to the different statins is highly unpredictable, determining a mandatory empirical molecule- and dose-finding strategy on the single patient, from the societal point of view the choice to start with lower cost molecules, among options that on average are equally-effective, may limit initial drug investment and dampen the impact of resource waste secondary to treatment interruptions and switches.
first_indexed 2024-12-13T11:24:58Z
format Article
id doaj.art-82e120e5cdea4fe4a76c3166be9b0ff6
institution Directory Open Access Journal
issn 2240-256X
language English
last_indexed 2024-12-13T11:24:58Z
publishDate 2006-09-01
publisher SEEd Medical Publishers
record_format Article
series Farmeconomia: Health Economics and Therapeutic Pathways
spelling doaj.art-82e120e5cdea4fe4a76c3166be9b0ff62022-12-21T23:48:16ZengSEEd Medical PublishersFarmeconomia: Health Economics and Therapeutic Pathways2240-256X2006-09-017314115410.7175/fe.v7i3.261236The clinical and economic value of lovastatin in the primary prevention of cardiovascular diseaseLorenzo Pradelli0Orietta Zaniolo1Centro di ricerche Farmacoeconomiche, Advanced Research srlCentro di ricerche Farmacoeconomiche, Advanced Research srlHMGCoA-inhibitors (statins) lower plasma cholesterol through interference with the rate-limiting enzyme in the endogenous synthesis process. Since their introduction in the early 90’s, the clinical attitude towards cardiovascular (cv) risk reduction has evolved from the attention to single risk factors to a more comprehensive global risk evaluation, and thus the indications of statins have broadened from the secondary prevention in hypercholesterolemic patients to include primary prevention in mildly and moderately hypercholesterolemic, or even normocholesterolemic patients, provided their global cv risk is considered high (typically, an estimated major cv event probability greater than 20%). Italian drug utilization data show that a small proportion of patients who could benefit from statins do actually receive them, contributing to the persistence of the clinical and economical burden of cv disease, the leading cause of mortality; since statins have proved effective, and cost-effective, in cv prevention, a more widespread use appears desirable, but requires high investments in pharmaceutical costs. This article defines a clinical profile of lovastatin, a statin with a solid efficacy and safety record only recently introduced into the Italian market despite it has been the first to become clinically available abroad. Among available statin formulations appropriate for target cholesterol reductions up to 30%, which apply to a significant proportion of statin therapy candidates, lovastatin 20 mg is marketed at the lowest price. Although the individual response to the different statins is highly unpredictable, determining a mandatory empirical molecule- and dose-finding strategy on the single patient, from the societal point of view the choice to start with lower cost molecules, among options that on average are equally-effective, may limit initial drug investment and dampen the impact of resource waste secondary to treatment interruptions and switches.https://journals.seedmedicalpublishers.com/index.php/FE/article/view/261hmgcoa-inhibitorsstatinslovastatinprimary preventioncost-efficacy
spellingShingle Lorenzo Pradelli
Orietta Zaniolo
The clinical and economic value of lovastatin in the primary prevention of cardiovascular disease
Farmeconomia: Health Economics and Therapeutic Pathways
hmgcoa-inhibitors
statins
lovastatin
primary prevention
cost-efficacy
title The clinical and economic value of lovastatin in the primary prevention of cardiovascular disease
title_full The clinical and economic value of lovastatin in the primary prevention of cardiovascular disease
title_fullStr The clinical and economic value of lovastatin in the primary prevention of cardiovascular disease
title_full_unstemmed The clinical and economic value of lovastatin in the primary prevention of cardiovascular disease
title_short The clinical and economic value of lovastatin in the primary prevention of cardiovascular disease
title_sort clinical and economic value of lovastatin in the primary prevention of cardiovascular disease
topic hmgcoa-inhibitors
statins
lovastatin
primary prevention
cost-efficacy
url https://journals.seedmedicalpublishers.com/index.php/FE/article/view/261
work_keys_str_mv AT lorenzopradelli theclinicalandeconomicvalueoflovastatinintheprimarypreventionofcardiovasculardisease
AT oriettazaniolo theclinicalandeconomicvalueoflovastatinintheprimarypreventionofcardiovasculardisease
AT lorenzopradelli clinicalandeconomicvalueoflovastatinintheprimarypreventionofcardiovasculardisease
AT oriettazaniolo clinicalandeconomicvalueoflovastatinintheprimarypreventionofcardiovasculardisease