Introduction: Medical innovation has frequently produced improvements in the length and quality of life, but at greater initial cost. It is natural to ask whether and to what extent the ultimate social value has exceeded the costs of these innovations for important medical breakthroughs. We analyze the social value of statins, an important and widely used class of drugs. We assess the hypothesis that the social value of statins exceeds their costs.

Methods: This retrospective analysis used survey data from the National Health and Nutrition Examination Study (NHANES) and estimates from a recent meta-analysis to quantify the impact of statin therapy on low-density lipoprotein cholesterol levels (LDL-C) and the number and cost of deaths, heart attacks and strokes. Additionally, the societal value of survival gains from statins was calculated using changes in life expectancy constructed from published mortality rates over a follow-up period of 15 years, and societal cost estimates were derived from U.S. expenditure data on all statins obtained from IMS Health. In these calculations, we assumed a value of life-year of $150,000 and a discount rate of 3%.

Results: In 2008, 34.8 million Americans (or 16.2% of the population) aged 20+ were found to use statins. Using population survey data, we estimate that the use of statin therapy was associated with a decrease in LDL-C of 21.6 mg/dL (or 19%), which translated into approximately 40,000 fewer deaths, 60,000 fewer heart attacks, and 22,000 fewer strokes in 2008. Statin treatment was associated with an expected 0.18-year gain in survival for each individual over a period of 15 years. Statin treatment has generated a benefit-to-cost ratio of over 4:1, leading to more than $500 billion (or $15,610 per user) in social value (expected longevity benefits minus drug costs) for the cohort of statin users in 2008 over a 15-year period.

Conclusions: For patients with elevated LDL cholesterol levels, statins have generated value in excess of costs. If statins were prescribed in full compliance with LDL cholesterol guidelines, our estimates suggest even greater longevity and health benefits.