This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.

The ultimate cost-effective therapy for cholesterol problems is niacin alone. It reduces levels of low-density lipoprotein cholesterol, increases levels of high-density lipoprotein cholesterol, reduces triglycerides and lipoprotein(a) concentrations, favorably alters the high-density lipoprotein₂–high-density lipoprotein₃ ratio, and changes particle size in low-density lipoprotein cholesterol subfractions from small and dense to large. No other drug shares all these advantages, or even the first 2.

Niacin has never been heavily promoted because it is not patentable; no single company can reap large profits from its exclusive sale. Furthermore, over the . . . [Full Text of this Article]