Abstract
Background
Prescribed statin therapy has contributed to a dramatic reduction in primary and secondary coronary heart disease (CHD). In the UK, simvastatin is currently available without prescription; however, the US FDA rejected an application for nonprescription lovastatin in 2005.
Objective and methods
We used population impact measures for three hypothetical levels of CHD risk to estimate the number of CHD events that would be prevented in the US over 5 years under three scenarios: (i) prescription-only regulations; (ii) approval of over-the-counter (OTC) statins; and (iii) implementation of lifestyle interventions.
Results
For people at very low risk of CHD, 429 299 CHD events could be prevented by the availability of OTC statins and 560 243 CHD events could be prevented among this group by implementing lifestyle interventions. For those at moderate risk of CHD, 244 388 CHD events could be prevented by OTC statins compared with 318 866 by lifestyle interventions. For people at high risk of CHD, prescription statins could prevent 374 897 CHD events over the next 5 years.
Conclusions
Provision of OTC statins to US adults at low or moderate risk of CHD would have a greater impact on CHD prevention than providing prescription statins for those at high risk of CHD. Provision of OTC statins alongside lifestyle interventions among those at low or moderate risk of CHD could substantially reduce the number of CHD events in the population.
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Acknowledgments
No sources of funding were used to assist in the preparation of this study. The authors have no conflicts of interest that are directly relevant to the content of this study.
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Gemmell, I., Verma, A. & Harrison, R.A. Should We Encourage Over-The-Counter Statins?. Am J Cardiovasc Drugs 7, 299–302 (2007). https://doi.org/10.2165/00129784-200707040-00007
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DOI: https://doi.org/10.2165/00129784-200707040-00007