In the base case, statin treatment in men aged 55 years with a 10-year vascular disease risk of 10%, resulted in a mean QALY gain of 0.020 (8.804 with no treatment and 8.824 with treatment) at 10 years. The mean additional costs with statin treatment were EUR 702 per person (EUR 1,875 with no treatment and EUR 2,577 for statin treatment). The incremental cost-effectiveness ratio was EUR 34,995 per QALY gained.
For men aged 65 years with a 10-year vascular disease risk of 10%, statins resulted in a larger QALY gain of 0.027 (8.152 without and 8.180 with statin) over ten years. The additional mean costs were EUR 672, resulting in an incremental cost-effectiveness ratio of EUR 24,607 per QALY gained.
The incremental cost-effectiveness ratio improved as the risk of vascular disease increased. In men aged 55 years, it ranged from EUR 5,395 to EUR 125,544 when the 10-year vascular disease risk varied from 25% to 5%.
The results were sensitive to the costs of statin treatment, statin effectiveness, non-adherence, disutility of taking medication daily, and the time horizon of the model. For instance, when the adherence levels from the trials were used, the cost per QALY gained with statins in 55-year-old men was EUR 25,848 (rather than EUR 34,995).
The probabilistic sensitivity analysis showed that at a threshold of EUR 20,000 per QALY gained, statin treatment was cost-effective in 16% of simulations for 55-year-old men with a 10-year vascular disease risk of 10%.
For women, the predicted health benefits were lower, producing slightly higher incremental cost-effectiveness ratios.