The scholarly exploration by Perreault et al1 of the cost-effectiveness of controlling hypercholesterolemia with lovastatin omitted several important considerations. A small but significant 1996 study2 showed that combining niacin, 500 mg 3 times per day, with lovastatin, 20 to 40 mg/d, controlled low-density lipoprotein cholesterol levels. The cost of the niacin-lovastatin combination was 40% less than that for therapy with only lovastatin.
Parsons WB. Cost-effective Treatment of Hypercholesterolemia. Arch Intern Med. 1998;158(15):1723–1724. doi:
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