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Trends in Lipid Lowering Prescriptions: Increasing Use of Guideline Concordant Pharmacotherapies — U.S., 2017–2022
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4 2023
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Source: Am J Prev Med. 64(4):561-566
[PDF-1.09 MB]
Details:
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Alternative Title:Am J Prev Med
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Personal Author:
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Description:Introduction:
Almost one-third of U.S. adults have elevated low-density lipid cholesterol (LDL-C) increasing their risk of atherosclerotic cardiovascular disease (ASCVD). The 2018 American College of Cardiology/American Heart Association Multisociety Cholesterol Management Guideline recommends maximally tolerated statin for those at increased ASCVD risk and add-on therapies (ezetimibe and PCSK9 inhibitors) in those at very high risk and an LDL-C≥70mg/dl. Prescription fill trends are unknown.
Methods:
Using national outpatient retail prescription data from Q1 2017–Q1 2022, authors determined counts of patients who filled who filled low-, moderate-, or high-intensity statins alone and with add-on therapies. Overall percent change and joinpoint regression were used to assess trends. Analyses were conducted March‒May 2022.
Results:
During Q1 2017–Q1 2022, patients filling a statin increased 25.0%, with the greatest increase in high-intensity statins (64.1%, 6.6–10.9 million). Low-intensity statins decreased 29.2% (3.3–2.4 million). Concurrent fills of high-intensity statin and ezetimibe rose 210% to 579,012 patients by Q1 2022, with an increase in slope by Q1 2019 for all statin intensities (p<0.01). Concurrent fills of a statin and PCSK9 inhibitor increased to 2,629, 16,169, and 28,651 by Q1 2022 for low-, moderate- and high-intensity statins, respectively. For patients on all statin intensities and PCSK9 inhibitor there were statistically significant increases in slope in Q2 2019 and decreases in Q1 2020.
Conclusions:
Patients filling moderate- and high-intensity statins and add-on ezetimibe, and PCSK9 inhibitors have increased, indicating uptake of guideline-concordant lipid-lowering therapies. Improvements in initiation and continuity of these therapies are important for ASCVD prevention.
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Source:
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Pubmed ID:36464556
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Pubmed Central ID:PMC10033441
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Funding:
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Volume:64
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Issue:4
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