The article on statins in the Health and Medicine column of Star Of Mysore
(12-10-11) appears to paint a much rosier picture of statins than is
warranted by published evidence. The article admits that there is
questionable cost effectiveness when statins are used for primary
prevention, but goes on to say that statins are effective in decreasing
mortality in people with pre-existing cardiovascular disease since
statins can cause upto 60% decrease in the number of cardiac events.
The clinical trial (Jupiter trial) which shows these results was a study of 18,000 people. The trial looked only at people who had low cholesterol and an elevated level of inflammation (as measured by CRP) and it looked only at the statin Crestor. The rate of heart attacks was 0.37% among patients who took a placebo and 0.17% among patients who took Crestor. So the study concluded that Crestor reduced heart attacks by 55%.
But a more careful analysis presented in the 31-3-10 issue of the prestigious daily New York Times shows that the benefit of Crestor is much less than it seems. The difference between the two groups translates to only 0.2 percentage points in absolute terms or 2 people out of 1,000. As N.Y. Times puts it, Stated another way, 500 people would need to be treated with Crestor for a year to avoid one usually survivableAt $3.50 a pill, the cost of prescribing Crestor to 500 people for a year would be $638,000 to prevent one heart attack. Spending Rs. 2.5 crores to prevent one usually survivable heart attack does not appear to be cost effective.
Recent studies have also found that use of statin may cause diabetes. A study published in the 27-2-2010 issue of the noted medical journal Lancet shows a 9% increased risk of diabetes for statin users.
C.V. Nagaraj, Mysore Grahakara Parishat