From 2002 to 2013, the use of statins in the U.S. increased 79.8 percent among adults who were at least 40 years old, according to a retrospective longitudinal cohort study.

However, statin use was significantly lower in high-risk subgroups such as women, racial/ethnic minorities and the uninsured. The researchers also noted the use of statins was suboptimal in participants with established atherosclerotic cardiovascular disease (ASCVD).

Meanwhile, the use of generic statins significantly increased during the time period, while the gross domestic product-adjusted total cost for statins and the mean annual out-of-pocket costs for patients significantly decreased.

Lead researcher Joseph A. Salami, MD, MPH, of the Center for Healthcare Advancement and Outcomes at Baptist Health South Florida in Miami, and colleagues published their results online in JAMA Cardiology on Nov. 14.

The findings were simultaneously presented in a poster session at the American Heart Association Scientific Sessions in New Orleans.

“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,” the researchers wrote.

The researchers analyzed data on 157,719 adults who participated in the Medical Expenditure Panel Survey (MEPS) from 2002 to 2013. The Agency for Healthcare Research and Quality sponsors the MEPS, which surveys individuals and families, clinicians and employers about their medical conditions and healthcare resource utilization and costs.

Of the adults, 24.6 percent used statins during the study period. The mean age of the participants was 57.7 years old, while 52.1 percent were female. More than 90 percent of the participants were diagnosed with hyperlipidemia.

The number of adults who used statins increased from 21.8 million (17.9 percent of the population) in 2002-2003 to 39.2 million (27.8 percent) in 2012-2013, which represented a 79.8 percent increase. During the study, the annual statin prescriptions increased 64.9 percent from 134 million to 221 million.

Of the participants with established ASCVD, 49.8 percent used statins in 2002-2003 and 58.1 percent used statins in 2012-2013.

Brand-name statins accounted for 91.6 percent of statin prescriptions in 2002-2003 and 18.2 percent of statin prescriptions in 2012-13. In 2012-13, simvastatin accounted for 41.4 percent of statin prescriptions, followed by atorvastatin (28.3 percent), pravastatin (16.2 percent), rosuvastatin (11.2 percent) and lovastatin (7 percent).

The annual total expenditures for statins decreased from $17.2 billion in 2002-2003 to $16.9 billion in 2012-2013. During that same time period, out-of-pocket expenditures decreased from $7.6 billion to $3.9 billion, while the mean per-user annual expenditures declined from $791 to $409. The mean per-user annual expenditures for branded statins increased from $808 to $1,188, but the expenditures for generic statins decreased from $498 to $227.

The researchers noted that the results were only generalizable to adults living in communities and not to those living in nursing homes. They also classified adults into ASCVD risk groups based in part on self-reports from participants. In addition, the study did not have information on the use of statins following the release of updated guidelines from the American College of Cardiology and American Heart Association in 2013.