KCE Reports 306 (2019)
A healthy lifestyle remains the most effective way of avoiding cardiovascular diseases and their consequences. Yet since 2002, the annual number of people who use cholesterol-lowering drugs from the statin family increased from 400,000 to 1,500,000. Currently, 25% of the population aged 40 and above take these drugs. Despite decreases in price due to the fact that all statins now exist in generic form, their total cost still stands at 160 million euros annually. Moreover, the analysis of individual consumption shows that, in Belgium, approximately 55% of new statin users do not take this treatment correctly or abandon it along the way. By lowering the blood cholesterol level, statins supposedly decrease the risk of myocardial infarct and cerebrovascular accident in primary prevention, that is, in persons who have not yet had this type of problem. But in terms of actual benefit for health, their adverse effects must also be taken into account. These adverse effects are, in fact, few in number but they are potentially serious. Thus in individuals with a low baseline risk, the potential benefits are limited, while the risk of adverse effects remains unchanged. It is therefore necessary to weigh the pros and cons carefully before prescribing them. We are currently developing a decision-making tool (online) which will allow physicians to assess these benefits and risks with each patient, to arrive together at a joint “informed” decision. This tool will be available over the course of 2019.