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

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-sect...

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Main Authors: Amro Matyori, Clyde P. Brown, Askal Ali, Fatimah Sherbeny
Format: Article
Language:English
Published: Elsevier 2023-06-01
Series:Saudi Pharmaceutical Journal
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1319016423000841
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author Amro Matyori
Clyde P. Brown
Askal Ali
Fatimah Sherbeny
author_facet Amro Matyori
Clyde P. Brown
Askal Ali
Fatimah Sherbeny
author_sort Amro Matyori
collection DOAJ
description 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.
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spelling doaj.art-b9ee26fff2e44127b627069d28386e692023-06-02T04:22:45ZengElsevierSaudi Pharmaceutical Journal1319-01642023-06-01316795800Statins utilization trends and expenditures in the U.S. before and after the implementation of the 2013 ACC/AHA guidelinesAmro Matyori0Clyde P. Brown1Askal Ali2Fatimah Sherbeny3Economic, Social, and Administrative Pharmacy Department, College of Pharmacy and Pharmaceutical Sciences, Florida Agricultural and Mechanical University, United StatesCollege of Pharmacy and Pharmaceutical Sciences, Institute of Public Health, Florida Agricultural and Mechanical University, United StatesEconomic, Social, and Administrative Pharmacy Department, College of Pharmacy and Pharmaceutical Sciences, Florida Agricultural and Mechanical University, United StatesEconomic, Social, and Administrative Pharmacy Department, College of Pharmacy and Pharmaceutical Sciences, Florida Agricultural and Mechanical University, United States; Corresponding author at: Economic, Social, & Administrative Pharmacy (ESAP), College of Pharmacy and Pharmaceutical Sciences, 1415 S. Martin Luther King, Jr. Blvd. Tallahassee, Florida 32307, East Wing Pharmacy Building Suite # L154N.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.http://www.sciencedirect.com/science/article/pii/S1319016423000841StatinsStatins costStatins utilizationStatins expenditureMedical Expenditure Panel Survey (MEPS)
spellingShingle Amro Matyori
Clyde P. Brown
Askal Ali
Fatimah Sherbeny
Statins utilization trends and expenditures in the U.S. before and after the implementation of the 2013 ACC/AHA guidelines
Saudi Pharmaceutical Journal
Statins
Statins cost
Statins utilization
Statins expenditure
Medical Expenditure Panel Survey (MEPS)
title Statins utilization trends and expenditures in the U.S. before and after the implementation of the 2013 ACC/AHA guidelines
title_full Statins utilization trends and expenditures in the U.S. before and after the implementation of the 2013 ACC/AHA guidelines
title_fullStr Statins utilization trends and expenditures in the U.S. before and after the implementation of the 2013 ACC/AHA guidelines
title_full_unstemmed Statins utilization trends and expenditures in the U.S. before and after the implementation of the 2013 ACC/AHA guidelines
title_short Statins utilization trends and expenditures in the U.S. before and after the implementation of the 2013 ACC/AHA guidelines
title_sort statins utilization trends and expenditures in the u s before and after the implementation of the 2013 acc aha guidelines
topic Statins
Statins cost
Statins utilization
Statins expenditure
Medical Expenditure Panel Survey (MEPS)
url http://www.sciencedirect.com/science/article/pii/S1319016423000841
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AT clydepbrown statinsutilizationtrendsandexpendituresintheusbeforeandaftertheimplementationofthe2013accahaguidelines
AT askalali statinsutilizationtrendsandexpendituresintheusbeforeandaftertheimplementationofthe2013accahaguidelines
AT fatimahsherbeny statinsutilizationtrendsandexpendituresintheusbeforeandaftertheimplementationofthe2013accahaguidelines