Sophisticated primary and secondary atherosclerosis prevention is cost effective.

Large clinical trials involving lipoprotein therapy and clinical end-points or arteriographic change have demonstrated a significant reduction in cardiovascular events and the need for cardiovascular procedures. Clinical end-point trials that used relatively weak treatment modalities have resulted in reduced clinical events and when the cost savings of the reduced number of events is balanced against the cost of treatment, the average difference is approximately US$1,500/patient/year. Arteriographic trials have used similar or more aggressive lipoprotein therapy over shorter periods of time. Similar estimates of cost savings from reduced clinical events balanced against the cost of treatment indicates a wide spectrum of estimated patient costs. These estimates range between a cost of $2,273/patient/year, to a cost savings of -$901/patient/year. Extrapolation to the United States population with coronary artery disease (CAD) suggests that greater than $1 billion per year could be saved if CAD patients received similar treatment and responded in a similar manner.