Gandjour Afschin
Frankfurt School of Finance & Management, Frankfurt, Germany.
PLoS One. 2025 Mar 13;20(3):e0318454. doi: 10.1371/journal.pone.0318454. eCollection 2025.
The German government has recently drafted a bill proposing a reduction in the prescription threshold for statin use. This study aims to determine the cost-saving risk threshold for statin use in Germany to inform this proposed change.
An economic evaluation utilizing a decision-analytic model was performed, using secondary data to compare statin use versus 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.
The maximum number needed to treat (NNT) to achieve cost savings over 10 years was found to be 39, leading to a minimum CV risk threshold for savings of 10.2%. It was estimated that approximately 19% of the adult population in Germany has a 10-year CV risk of ≥ 10.2%, potentially avoiding between 271,739 and 581,363 CV events over 10 years, with net population savings of approximately €15 billion.
A threshold for statin prescription in Germany set at a 10.2% 10-year CV risk 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.
德国政府最近起草了一项法案，提议降低他汀类药物使用的处方门槛。本研究旨在确定德国他汀类药物使用的成本节约风险阈值，为这一提议的变更提供依据。
利用决策分析模型进行了一项经济评估，使用二手数据从德国疾病基金参保人的角度比较他汀类药物使用与不使用他汀类药物的情况。分析重点在于避免心血管（CV）事件带来的成本节约，在考虑治疗成本和潜在副作用后，将这些避免的事件转化为净节约。该研究考虑了由疾病基金承保的德国成年人口，并采用终身视角进行分析。
发现10年内实现成本节约所需治疗的最大人数（NNT）为39，这导致节约成本的最低CV风险阈值为10.2%。据估计，德国约19%的成年人口10年CV风险≥10.2%，在10年内可能避免271,739至581,363次CV事件，净人口节约约150亿欧元。
将德国他汀类药物处方阈值设定为10年CV风险10.2%，可显著增加受益于他汀类药物治疗的患者数量，减少CV事件并产生大量成本节约。这些发现表明，调整处方指南可改善德国医疗保健系统内的心血管结局和经济效率。
