A new study led by researchers at Oxford Population Health’s Economics of Population Health Research Centre has found that while statin therapy reduces the rates of hospital admissions and prescription medications over a person's lifetime, it also leads to greater overall healthcare use in the long run because people taking statins live longer.
The findings highlight the need for long-term healthcare planning to accommodate changing patterns of demand. The study is published in Value in Health.
Statins are widely prescribed to lower cholesterol and reduce the risk of heart attacks, strokes and death from cardiovascular disease. The clinical benefits and cost-effectiveness of statin therapy are well established but, until now, little was known about how statins affect people's use of health services, such as hospital admissions, GP consultations, tests and prescriptions, over the course of their lives.
Our findings have broader implications for preventive treatments that reduce disease risk and extend survival, highlighting the need for healthcare services to plan proactively for changing patterns of demand.
- Professor Borislava Mihaylova
In this study, researchers used data from over 500,000 UK Biobank participants, including their hospital records and, for about 200,000 of them, also their primary care records. They built statistical models estimating how much healthcare people used following a major cardiovascular event, such as a heart attack, stroke, or coronary revascularisation procedure, and integrated these into a validated cardiovascular disease microsimulation model. This allowed them to simulate lifetime patterns of healthcare use for people with and without statin treatment, across four groups defined by age (40–60 and 60–70 years) and whether they had prior history of cardiovascular disease.
Key findings:
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Cardiovascular events triggered large short-term increases in healthcare use. In the year of a heart attack, stroke, or coronary revascularisation, the number of hospital admissions, bed-days, GP consultations, tests, and prescriptions all rose sharply before easing off over the following two years;
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Over a lifetime, statin treatment reduced the proportion of people experiencing a new major vascular event by between 7.5% and 11.5%, and increased life expectancy by between 0.64 and 0.94 years, depending on age and prior cardiovascular disease history;
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Statin treatment lowered the annual rate of hospital bed-days and prescription medication use per person-year over a lifetime;
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However, because people on statins lived longer, their cumulative use of healthcare services was initially lower than that of untreated people, but became higher in the longer term.
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The turning point came sooner for primary care tests and consultations (roughly 9 to 17 years after starting treatment) and later for hospital bed-days (40 to 51 years after starting treatment), with earlier transitions in older people and those with existing cardiovascular disease.
Junwen Zhou, Senior Researcher at the Economics of Population Health Research Centre and first author of the study, said:
Statins clearly reduce the risk of heart attacks and strokes, and the demand on healthcare systems in the years after people start treatment. But because statins help people live longer, their overall lifetime use of health services eventually rises above that of people who never took the drug.
‘This isn't a reason to avoid statins, given their well-established benefits for health and quality of life. Instead, it highlights the need for long-term healthcare planning to accommodate the increased service use that comes with a longer-living, statin-treated population.’
Borislava Mihaylova, Professor of Health Economics at Oxford Population Health and senior author of the study added ‘As statin use continues to increase, healthcare systems should anticipate a shift in demand away from acute cardiovascular care and towards sustained preventive, chronic disease, and age-related care, ensuring that services are appropriately configured to meet changing patterns of need.
'Our findings have broader implications for preventive treatments that reduce disease risk and extend survival, highlighting the need for healthcare services to plan proactively for changing patterns of demand.'