To the Editor.—
The analysis of cost-effective alternatives for treating hypercholesterolemia by Drs Kinosian and Eisenberg1 published in the April 15 issue of JAMA provides important information for discussion of the treatment of risk factors for coronary heart disease. Updates of several studies mentioned in their article provide additional information relevant to the analysis of their article.The authors used a dosage of oat bran of 90 g/d to predict a 13% reduction in cholesterol level during the initial year and an overall reduction of 8.7% over seven years. A recent study published by Anderson2 indicates that 50 g of oat bran was as effective as 100 g/d and produced overall cholesterol level reductions of 19.8%. The lower oat bran dosage could reduce the authors' cost estimates for oat bran by 44%, to a cost per year of life saved of $9968, making this treatment even more cost-effective.