CHD is the major cause of death in US, the UK and many other developed countries, with most deaths resulting from a heart attack. In SSt's target markets, there are an estimated 273m people with elevated levels of cholesterol and a further 64m people with high levels of cholesterol. These figures reflect the incidence of overweightness and obesity, which is between 20% and 50% of the population in the developed countries. For example, in the US there are 106.9m overweight adults and 43.6m obese adults, while 100.9m adults have elevated cholesterol and 40.6m have high cholesterol.

High cholesterol is becoming an increasing health risk, particularly as more people become overweight and obese. It is widely accepted that periodic screening for high cholesterol would benefit millions of people and many organisations (including the American Heart Association; Chest, Heart & Stroke Scotland; US Preventative Services Task Force) advocate screening from as early as age 20 years at intervals varying from 2 to 5 years depending on risk factors.

The cost of CHD in the UK was estimated in 1996 at $15bn. In the US , the total cost of CHD during 2001 was estimated at $53bn in direct medical costs and a further $47bn in indirect costs.

The chart opposite shows the incidence of elevated cholesterol in the West.

The most common group of cholesterol lowering drugs is the statins. The major effect of statins is to lower LDL-cholesterol levels and statins do this more effectively than other types of drugs. Statins lower cholesterol by slowing down the production of cholesterol and by increasing the liver's ability to remove the LDL-cholesterol already in the blood. The large reductions in total and LDL-cholesterol produced by statins results in large reductions in heart attacks and heart disease deaths.

The market for statins in 2000 was $16.7bn and is forecast to grow to $25bn in 200. Pfizer's Lipitor has the highest sales, at $7bn in 2001, with a forecast potential of $10bn. There is a non-compliance rate as high as 70% among patients taking statins and motivating patients to take their medication is both a top therapeutic priority and a marketing concern, with an annual course of therapy worth as much as $1000 per patient.

The chart opposite shows the growth of the statin market.