- Prescribing Advice for GPs - https://www.prescriber.org.uk -

Cost efficacy of aspirin in primary prevention

Circulation has published the results of an analysis into the cost effectiveness of aspirin in primary prevention based on gender and predicted cardiovascular risk.

The analysis is based on population modelling using data from Dutch populations. The paper concludes that treatment is "cost-effective for men with a 10-year cardiovascular disease risk of >10% and for women with a risk of >15%".

A similar analysis undertaken several years ago by Bandolier examined the risks and benefits of treatment. It concluded that treatment was safe and worthwhile at a coronary risk of >15% in 10 years (approximately 20% CVD risk). It was also noted that treatment safe but of limited value in terms of risks and benefits at 10% CHD risk over 10 years (approximately 15% CVD risk).

Action: Clinicians should ensure that any patient whose cardiovascular risk is estimated at greater than 20% in 10 years should be offered treatment with low-dose aspirin and a cost-effective statin (usually simvastatin 40mg).