Economic implications of lipid-lowering trials: current considerations in selecting a statin.

Little doubt remains about the value of lipid-lowering therapy since publication of the results of large, randomized, controlled trials that show decreased total, as well as coronary, mortality with the use of statins for primary and secondary prevention of coronary artery disease. All of the available statins are effective and safe, but they vary greatly in terms of cost-effectiveness. Fluvastatin has been determined to be a cost-effective therapeutic agent in the large proportion of the population with mild-to-moderate dyslipidemia who fit treatment guidelines of the National Cholesterol Education Program (NCEP). Atorvastatin and simvastatin are cost-effective for the relatively smaller number of patients who require greater reductions in cholesterol.