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Simvastatin was cost effective across a broad range of risk and age groups

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 Q Is 40 mg/day of generic simvastatin continued for life cost effective in patients of different ages with differing risks of vascular disease?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Cardiology ★★★★★★☆ Internal medicine ★★★★★☆☆


Embedded ImageDesign:

cost effectiveness study using a Markov model developed from a randomised {allocation concealed*}, blinded {patients, clinicians, data collectors, and outcome assessors},* placebo controlled trial with mean 5 year follow up (Heart Protection Study [HPS]).

Embedded ImageSetting:

69 UK hospitals.

Embedded ImagePatients:

20 536 patients 40–80 years of age with total cholesterol concentrations ⩾3.5 mmol/l (135 mg/dl) and history of coronary disease, cerebrovascular disease, other occlusive arterial disease, diabetes mellitus, or treated hypertension (in men ⩾65 y). Within the HPS, patients were divided into 5 similar sized groups by estimated 5 year risk of a major vascular event (12%, …

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  • * See glossary.

  • For correspondence: Heart Protection Study, Clinical Trial Service Unit, Oxford, UK. hps{at}

  • Sources of funding: UK Medical Research Council; British Heart Foundation; Merck & Co; Roche Vitamins Ltd.

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