Miami, FL—Prescriptions for statins soared 80% from 2002 to 2013, but the costs of the cholesterol-lowering agents plummeted as generics became the drugs of choice, according to a new study.
Usage in some subgroups—women, racial/ethnic minorities, and the uninsured—didn’t keep pace, however, and prescriptions for clinically high-risk groups also remain too low, according to the report published online by JAMA Cardiology in conjunction with its presentation at the American Heart Association’s Scientific Sessions 2016.
Current guidelines from the American Heart Association and the American College of Cardiology expanded the indications for statins, according to the report from Baptist Health South Florida researchers and colleagues, leading to an increase in use of the drugs from 37.5 million, 37.5%, to 56 million, 48.6%, over the 11-year period.
For the study, investigators used the Medical Expenditure Panel Survey database to focus on trends in use, as well as total and out-of-pocket (OOP) expenditures for statins for adults ages 40 and older.
Overall, with the average participant available for the study being 58 years of age and female, statin usage jumped 80%, from 21.8 million patients and 134 million prescriptions at the beginning of the time period to 39.2 million patients with 221 million prescriptions at the end.
Yet the gains among patients with established atherosclerotic cardiovascular disease (ASCVD) were not as great. In that group, statin use was 50% from 2002 to 2003 versus 58% from 2012 to 2013, study authors note, adding that fewer than a third were prescribed as a high-intensity dose.
During the study period, the proportion of prescriptions for generic statins soared from 8.4% to 82%, so that gross domestic product–adjusted total cost for statins decreased from $17.2 billion (OOP cost, $7.6 billion) in 2002-2003 to $16.9 billion (OOP cost, $3.9 billion) in 2012-2013. That translated to an OOP cost drop from $7.6 billion to $3.9 billion, while the average annual cost for patients declined from $348 to $94, according to the results.
By the end of the study period, brand-name statins were used by only 18% of patients but accounted for 55% of total costs.
“While total and OOP expenditures associated with statins decreased, further substitution of brand-name to generic statins may yield more savings,” the authors suggest, concluding, “These findings have important public health implications and should stimulate further discussions among stakeholders for pragmatic patient-centered interventions to improve appropriate statin use and manage associated costs.”
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