Statins: modelling study suggests lifespan benefits are not evenly distributed and that people may not choose the mathematically optimal option for benefit

New Medicines Evidence Commentary from NICE:

A 3-part study has found that, according to a model based on UK population data, starting preventive therapy in people at risk of cardiovascular disease produces greater mean gain in lifespan in people aged 50–54 years than in older people (although quality of life was not modelled). It also suggests that the actual lifespan gain is not evenly distributed: most people gain no lifespan whereas a few gain a great deal, with a greater proportion of people benefiting among those at greater baseline risk. Finally, members of the public were asked to choose between the option of a 1 year gain in healthy life span for sure or a certain percentage chance (2%, 5%, 10%, 20% or 50%) to gain 10 years healthy lifespan. Although in each comparison the majority chose the option with the greatest mean gain, substantial proportions of people preferred the ‘sure thing’ over percentage options that offered a greater mean gain. This study should help to inform shared decision-making and elicitation of individual preferences, in terms of communicating risk in practice and in guideline development.