Cost / Benefit
Since its introduction, the price of lipid-lowering drugs and their benefits in atherosclerosis has been much debated. Although this has affected the other statins, simvastatin was the first statin drug to be used extensively in clinical practice.
A number of large epidemiological studies were conducted to discover which patients would benefit most from statin drugs; most studies involve simvastatin as the study drug. The most influential studies were the Scandinavian Simvastatin Survival Study (4S) and the Heart protection study (HPS).
It has been suggested that patients with one or more risk factors for cardiovascular disease (such as diabetes mellitus, hypertension, or a positive family history) can benefit from statins, even if they do not have substantially elevated cholesterol levels. This is the hypothetical concept of "total risk", by combining particular risk factors.
Simvastatin was introduced in the late 1980s, and since 2006 in many countries, it is available as a generic preparation. This has led to a decrease of the price of most statin drugs, and a reappraisal of the health economics of preventive statin treatment. In the UK in 2008, the typical per patient cost to the NHS of simvastatin was about £1.50 per month. (40 mg/day costs UK NHS £1.37/month in 2012)
Read more about this topic: Simvastatin
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