Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Mar 13;20(3):e0318454.
doi: 10.1371/journal.pone.0318454. eCollection 2025.

Determining cost-saving risk thresholds for statin use

Afschin Gandjour  1
Affiliations

Determining cost-saving risk thresholds for statin use

Afschin Gandjour. PLoS One. .

Abstract

Background: The German government has recently drafted a bill proposing a reduction in the prescription threshold for statin use. This study aims to determine the cost-saving risk threshold for statin use in Germany to inform this proposed change.

Methods: An economic evaluation utilizing a decision-analytic model was performed, using secondary data to compare statin use versus no statin use from the perspective of German sickness fund insurees. The analysis focused on cost savings from avoided cardiovascular (CV) events, translating these avoided events into net savings after accounting for treatment costs and potential side effects. The study considered the German adult population insured by sickness funds and used a lifetime horizon for the analysis.

Results: The maximum number needed to treat (NNT) to achieve cost savings over 10 years was found to be 39, leading to a minimum CV risk threshold for savings of 10.2%. It was estimated that approximately 19% of the adult population in Germany has a 10-year CV risk of ≥ 10.2%, potentially avoiding between 271,739 and 581,363 CV events over 10 years, with net population savings of approximately €15 billion.

Conclusions: A threshold for statin prescription in Germany set at a 10.2% 10-year CV risk could significantly increase the number of patients benefiting from statin therapy, reducing CV events and generating substantial cost savings. These findings suggest that adjustments to prescription guidelines could improve cardiovascular outcomes and economic efficiency within the German healthcare system.

PubMed Disclaimer

Conflict of interest statement

The author has declared that no competing interests exist.

Figures

Fig 1
Fig 1. Estimated distribution of 10-year cardiovascular risk in the German population.
Dashed lines indicate minimum cost-saving threshold and average risk with a risk above the threshold.
Fig 2
Fig 2. One-way sensitivity analysis of the cost-saving threshold for 10-year cardiovascular risk.
Variables are arranged in order of their impact on the 10-year risk threshold. MI: myocardial infarction.
See this image and copyright information in PMC

References

    1. Laufs U, Scharnagl H, Halle M, Windler E, Endres M, März W. Treatment options for statin-associated muscle symptoms. Dtsch Arztebl Int. 2015;112(44):748–55. doi: 10.3238/arztebl.2015.0748 - DOI - PMC - PubMed
    1. Salam B, Schrimpf A, Münster S, Bleckwenn M. Statin adherence in patients enrolled in the disease management program for coronary artery disease - comparison between patients’ and general practitioners’ self-reports and patient records. Res Health Serv Reg. 2023;2(1):13. doi: 10.1007/s43999-023-00029-3 - DOI - PMC - PubMed
    1. Koenig W, Lorenz ES, Beier L, Gouni-Berthold I. Retrospective real-world analysis of adherence and persistence to lipid-lowering therapy in Germany. Clin Res Cardiol. 2024;113(6):812–21. doi: 10.1007/s00392-023-02257-6 - DOI - PMC - PubMed
    1. Scheidt-Nave C, Du Y, Knopf H, Schienkiewitz A, Ziese T, Nowossadeck E, et al.. Prevalence of dyslipidemia among adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS 1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56(5–6):661–7. doi: 10.1007/s00103-013-1670-0 - DOI - PubMed
    1. Knopf HC, Busch MA, Du Y, Truthmann J, Schienkiewitz A, Scheidt-Nave C. Changes in the prevalence of statin use in Germany - findings from national health interview and examination surveys 1997-1999 and 2008-2011. Z Evid Fortbild Qual Gesundhwes. 2017;122:22–31. doi: 10.1016/j.zefq.2017.04.001 - DOI - PubMed

Substances

LinkOut - more resources