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. 2023 Jun;31(6):795-800.
doi: 10.1016/j.jsps.2023.04.002. Epub 2023 Apr 11.

Statins utilization trends and expenditures in the U.S. before and after the implementation of the 2013 ACC/AHA guidelines

Amro Matyori  1 , Clyde P Brown  2 , Askal Ali  1 , Fatimah Sherbeny  1
Affiliations

Statins utilization trends and expenditures in the U.S. before and after the implementation of the 2013 ACC/AHA guidelines

Amro Matyori et al. Saudi Pharm J. 2023 Jun.

Abstract

Importance: Statins are drugs of choice in treating hyperlipidemia and preventing or reducing cardiovascular diseases.

Purpose: Explore statins utilization and expenditure trends in the United States before and after the publication of the 2013 ACC/AHA guidelines.

Method: A retrospective, cross-sectional study of US noninstitutionalized civilians was conducted using MEPS data from 2008 to 2019. Adults who were ≥ 40 years old and who reported taking statins were included in the study.

Primary outcomes: Statins use patterns, total cost, and out-of-pocket spending in the general adults who reported taking statins medications. Expenditures were expressed in 2019 US dollars.

Results: In this study, 409,804 individuals were eligible to be included (mean age [SE], 59 [0.1] years; 54% female). Of those participants, 22% reported taking statin therapy, and 11% of them filled only one statin prescription. The number of individuals in the general population who reported taking any statin climbed from 31 million (12%) in 2008-2009 to 92 million (35%) in 2018-2019, representing a 197% increase. After 2013, the number of individuals who used statins increased by 149%, from 37 million in 2012-2013 to 92 million users in 2018-2019. The annual number of statins prescriptions increased from 461 million to 818 million (77%; p = 0.000) between 2008 and 2019. Atorvastatin was the most prescribed medication in the statins class (36%), followed by simvastatin (34%). The moderate-intensity statins were the most used by the participants (60%). The total statins cost in 2013 was $8 billion and increased to $10 billion in 2019 (25%; p = 0.000). The total OOP expenditure trend sloped from $4.0 billion in the 2008-2009 cycle to $3.1 billion in 2018-2019. The average OOP paid by Asians was higher than that of other races at $141.

Conclusion: The proportion of individuals who used statins significantly increased following the adoption of the 2013 ACC/AHA guidelines. The findings, however, demonstrated suboptimal prescribing trends of high-intensity statins, which need to be addressed by the stakeholders to maximize medication outcomes. Statins expenditures, especially the co-payments, significantly decreased. The results have shown that revised or new regulations have a substantial impact on the healthcare industry.

Keywords: Medical Expenditure Panel Survey (MEPS); Statins; Statins cost; Statins expenditure; Statins utilization.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Trends in Statins Utilization, MEPS 2008–2019.
Fig. 2
Fig. 2
Number of Statins Prescriptions, MEPS 2008–2019.
Fig. 3
Fig. 3
Statins Prescription Purchase based on Age Groups, MEPS 2008–2019.
Fig. 4
Fig. 4
Utilization of Statins by Type, MEPS 2008–2019.
Fig. 5
Fig. 5
Statins Utilization Trend by Intensity, MEPS 2008–2019.
Fig. 6
Fig. 6
Annual Total Expenditures Trend of Statins, MEPS 2008–2019.
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