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. Author manuscript; available in PMC: 2016 Jul 14.
Published in final edited form as: JAMA. 2015 Jul 14;314(2):142–150. doi: 10.1001/jama.2015.6822

Table 2.

Individual Lifetime Clinical Outcomes, QALYs, Costs, and ICERs for Base-Case Analysis

ACC/AHA ASCVD
Risk Threshold, %		 Adults Statin
Eligible, %		 Statin-Induced
Diabetes Casesa 		CVD Eventsa,b Life Expectancy, y QALYsc Costs, 2013
US $c 		ICER (US $/QALY)
No ASCVD
threshold		     8 0.0019 0.4493 81.237 17.276 21 310 1 [Reference]
≥30.0   34 0.0030 0.4437 81.265 17.287 21 649 Extended dominanced
≥20.0   36 0.0039 0.4405 81.293 17.299 21 898 Extended dominanced
≥15.0   39 0.0045 0.4384 81.315 17.309 22 109   24 000/QALY
≥10.0   44 0.0055 0.4365 81.341 17.320 22 455   30 000/QALY
≥7.5e   48 0.0062 0.4353 81.356 17.327 22 696   37 000/QALY
≥5.0   57 0.0072 0.4344 81.371 17.333 23 039   57 000/QALY
≥4.0   61 0.0076 0.4340 81.377 17.335 23 200   81 000/QALY
≥3.0   67 0.0080 0.4337 81.382 17.336 23 406 140 000/QALY
≥2.0   75 0.0085 0.4334 81.386 17.337 23 656 830 000/QALY
≥1.0   87 0.0091 0.4333 81.389 17.336 23 952 Strong dominancef
Treat all adults
with statins		 100 0.0097 0.4332 81.391 17.334 24 225 Strong dominancef

Abbreviations: ACC/AHA, American College of Cardiology and American Heart Association; ASCVD, atherosclerotic cardiovascular disease; ICER, incremental cost-effectiveness ratio; QALYs, quality-adjusted life-years.

a

Values indicate proportion of all adults that experience this outcome at some point in their lifetime. Results for statin-induced diabetes cases and CVD events correspond to the average lifetime risk of experiencing each of these outcomes for individuals in the model population.

b

Defined as nonfatal or fatal: myocardial infarction, angina, cardiac arrest, or stroke.

c

Discounted at 3%.

d

Extended dominance: other, more effective strategies have lower cost-effectiveness ratios than this strategy.

e

ASCVD risk threshold used in 2013 ACC/AHA guidelines.

f

Dominated: other strategies are less costly and more effective than this strategy. Based on recommendations, strategies that are dominated by either mechanism (strong dominance or extended dominance) are eliminated from further consideration in a cost-effectiveness analysis.