Disadvantaged groups more likely to be recommended for statin use, less likely to afford it

Recent guidelines in the U.S. suggest cholesterol-lowering statins should be prescribed more widely to prevent heart disease and aid diabetics, but most people who are newly recommended for the medication can’t afford it.

More than 18 million more Americans are eligible for statin use under the newest American College of Cardiology (ACC) and American Heart Association (AHA) guidelines, which were published in 2013, a recent study stated. More than half of those individuals are non-Caucasian, and many have lower income levels and are less likely to have access to health insurance.

Senior author Fahad Razak, MD, and colleagues at St. Michael’s Hospital in Toronto studied the medical data of more than 5,000 individuals and extrapolated that sample size to 117.6 million U.S. adults. Of that number, 54.1 percent were recommended for statin use under the 2013 ACC/AHA guidelines, and 39.2 percent were eligible for use based on the Adult Treatment Panel III guidelines, which were also published in 2013. Data from between 2005 and 2012 was pulled from the National Health and Nutrition Examination Survey, and all participants were between 40 and 75 years old.

As predicted, statin eligibly increased across all demographic groups studied, including race, education and income. Still, socioeconomic gaps remained significant.

It was more common for people of color, those without a college degree, low-income earners and individuals without health insurance to be newly eligible for statins, according to the study. More than a quarter of all newly eligible patients were black, and 17 percent had no health coverage. Just 14.5 percent of newly eligible patients were white and 13 percent completed college.

“Medical experts recommend that more Americans should take statins, especially among vulnerable populations,” Razak said in a release from St. Michael’s Hospital. “But if health insurance coverage and access to healthcare are not increased, these recommendations will not make an impact to improve the health of Americans.”

Due to socioeconomic disadvantages and lack of adequate health insurance, more than 3 million people of color, 3.6 million individuals who didn’t go to college and 4.1 million people with low income are recommended for statin use but likely won’t have feasible access to the treatment, the study’s authors wrote. Black patients were almost four times more likely to be recommended for statin use than white patients, but less likely to be able to afford the pricey medications.

While 95 percent of the study’s top-earning white patients—and 89 percent of all Caucasians analyzed—received health insurance between 2005 and 2012, just 58 percent of Mexican-Americans had that same privilege. Still, people without health insurance were found to be recommended for statins 1.5 times more than those with it.

Lead author Amol Verma, MD, said in the release that while it’s good doctors are more readily prescribing helpful medications to prevent cardiovascular disease and its risk factors, those medications won’t help if patients can’t afford them.

“There’s been a general shift among clinicians to be more aggressive in prescribing these medications and controlling these risk factors more tightly,” Verma said. “But if we don’t focus on delivering the care to disadvantaged groups, the benefits won’t be realized.”