AJC: Statin adherence is costly for patients, cheaper for providers

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More than 50 percent of patients administered statins show a decline in adherence within the first year due to side effects or costs. However, research published June 1 in the American Journal of Cardiology found that adhering to statin therapy was connected to decreased healthcare costs and cardiovascular (CV) disease-related hospitalizations.

More than 34 million Americans are currently being treated for high cholesterol and typically statins are prescribed to lower LDL cholesterol. “[T]o achieve the best possible outcome, it is important for patients to adhere to their statin medication regimen,” Donald G. Pittman, of the Medco Research Institute in Franklin Lakes, N.J., and colleagues wrote.

To better outline the healthcare costs associated with statin adherence, Pittman and colleagues used the National Medco Integrated Database System to perform an analysis of patients age 18 to 61 who received statin therapy between January 2007 and June 2009—381,422 patients were included.

Fifty-nine percent of patients in the study were male and the average age was 53 years. Additionally, 52.1 percent were hypertensive, 25.4 percent were diabetic and 15.2 percent had coronary artery disease.

The researchers determined adherence by calculating their patients' medication possession ratio (MPR). Patients were divided into three adherence categories: adherent (MPR >80 percent), moderately adherent (MPR 60 to 70 percent) and low adherence (MPR 0 to 59 percent). For the study, they reviewed healthcare costs and CV-related hospital admissions.

Of the study population, 67.7 percent were adherent to statin medication while 32 percent were not. The researchers said more than half of non-adherent patients had an MPR less than 60 percent.

Prescription costs for adherent patients had a price tag of $10,198 per patient over a 18-month span compared with $10,609 and $11,102 for moderate adherence and low adherence patients. For patients with an MPR that was greater than 90 percent, costs were estimated to be $944 less per patient when compared to patients whose MPRs were less than 60 percent.

What was surprising, according to the researchers, was that while statin and prescription costs were most expensive in the more adherent groups, medical costs were were lower in more adherent groups, which led to lower overall healthcare costs.

Pittman and colleagues said that patient education can improve medical adherence. “Healthcare providers need to maintain an open dialogue with their patients to discuss cost-effective alternatives (e.g., generics or utilizing mail-order pharmacies), behavioral barriers and common side effects,” the authors noted.

Medical adherence can not only reduce the risk of CVD and decrease hospitalizations but can also reduce medical care costs.

Medco Research Institute is a research organization that performs research and analytics regarding patient outcomes and healthcare costs.