What does this research mean for the field?

Using LDL-C thresholds of 3.4 mmol/L and 2.6 mmol/L for statin therapy in Chinese adults balances clinical effectiveness with cost efficiency, achieving an ICER of US$22,901 per QALY gained. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

February 6, 2026European Heart Journal

Cost-effectiveness of statin therapy for primary prevention of cardiovascular disease based on different LDL-C targets: a modelling study

Q: What is the clinical evidence from this study?

Population: primary prevention of cardiovascular disease (n=324600000). Intervention: Statin therapy based on different LDL-C targets vs. No statin treatment. Primary outcome: Number of CVD events prevented, NNT to prevent one CVD event, QALYs gained, and ICER.

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Key result

Statin initiation at 3.4 and 2.6 mmol/L LDL-C thresholds achieves cost-effectiveness at ~$22,901 per QALY.

NNT 27
NNT 27
n=324,600,000

Why the study?

Recommended LDL-C targets for CVD primary prevention vary across guidelines, and statin coverage remains suboptimal, particularly in low- and middle-income countries.

Does statin therapy guided by tailored LDL-C thresholds improve cost-effectiveness and prevent CVD events in statin-naïve Chinese adults without diabetes or prior CVD?

Population

Simulated Chinese adults aged 40-80 free of diabetes and CVD history, statin-naïve (representing 324.6 million)

Comparison

Eight statin strategies by LDL-C thresholds across CVD risk categories vs no statin treatment

Design

Microsimulation modelling study

Follow-up

10-year horizon

Authors

QLQ LiuPeking University MLM LuKing University YGY GuoPeking University

Discussion

Member takes

Implication

May inform tailored LDL-C statin thresholds in Chinese adults; extends modeling data but leaves RCT confirmation open.

Key Points

To evaluate the cost-effectiveness of statin therapy for primary prevention of cardiovascular disease in China based on various LDL-C targets.
Developed a microsimulation model to project costs and outcomes over 10 years
Simulated data from CHARLS study of adults aged 40-80 free of diabetes and CVD
Evaluated eight scenarios with different LDL-C thresholds across three CVD risk categories
All strategies proved cost-effective with ICERs below three times China's GDP
Intensive strategy prevented 6.81 million CVD events but had the highest cost of US$160.07 billion
Modified strategy per 2019 ESC guidelines prevented 6.72 million events with lower ICER of US$27,467 per QALY
Uniform strategy prevented 1.72 million events with significantly lower costs (US$40.71 billion)

Structured PICO

Does statin therapy guided by tailored LDL-C thresholds improve cost-effectiveness and prevent CVD events in statin-naïve Chinese adults without diabetes or prior CVD?

Population

Simulated cohort representing 324.6 million Chinese adults aged 40-80 without diabetes or prior CVD, who were statin-naïve, evaluated over a 10-year horizon.

Intervention

Various statin initiation strategies applying different LDL-C thresholds (3.4 mmol/L, 2.6 mmol/L, and 1.8 mmol/L) across three CVD risk categories (low, moderate, and high), including modified strategies based on international guidelines.

Comparator

No statin treatment and a uniform strategy (3.4 mmol/L threshold for all risk groups).

Outcome

Number of CVD events prevented, number needed to treat (NNT) to prevent one CVD event, QALYs gained, and the incremental cost-effectiveness ratios (ICER) over a 10-year horizon.hard clinical

Main Result

Number Needed to Treat: 27

A tailored statin initiation strategy using specific LDL-C thresholds for moderate- and high-risk adults optimally balances clinical effectiveness with cost efficiency in the Chinese population.

Cite This Study

Liu et al. (2025) studied primary prevention of cardiovascular disease (n=324,600,000). Statin therapy based on different LDL-C targets vs. No statin treatment was evaluated on Number of CVD events prevented, NNT to prevent one CVD event, QALYs gained, and ICER. A modified statin therapy strategy per the 2016 ESC guideline optimally balanced clinical effectiveness and cost efficiency, with an NNT of 27 to prevent one CVD event and an ICER of $22,901/QALY.

synapsesocial.com/papers/698586ad8f7c464f2300a78e https://doi.org/10.1093/eurheartj/ehaf784.4594

Topics

Cardiovascular prevention Statin therapy

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Cost-effectiveness of statin therapy for primary prevention of cardiovascular disease based on different LDL-C targets: a modelling study

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Cite This Study

Topics

Cost-effectiveness of statin therapy for primary prevention of cardiovascular disease based on different LDL-C targets: a modelling study

Discussion

Member takes

Implication

Key Points

Structured PICO

Main Result

Cite This Study

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Topics

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