Lipid Research Clinics Program

To the Editor.— The article by the Lipid Research Clinics Program¹on reduction in instances of coronary artery disease was a very useful study for the physician interested in primary prevention of coronary artery disease. I have had relatively poor success keeping patients on a regimen of cholestyramine in my own practice because of the cost. The least expensive form of cholestyramine resin available through a local pharmacy would cost my patient $31.20 a week to take 24 g/day. This comes to a total cost of $1,622.40 a year. If, as the study suggests, there are 1 1/2 million Americans who would qualify for this form of therapy, the cost considerations become impressive. Some simple arithmetic demonstrates that the cost nationwide for each patient spared a cardiac end point is $715,764.70. Who says that coronary artery surgery is expensive?