Adherence to Statins, Subsequent Healthcare Costs and Cardiovascular Related Hospitalizations

More than 34 million Americans are being treated for high cholesterol, a condition that can increase the risk of coronary heart disease (CHD), stroke and death due to CHD. In order to achieve goals set for a patient’s low-density lipoprotein-cholesterol (LDL-C), it is important to adhere to statin medications. However, due to side effects, medication costs, or lack of symptoms associated with the condition, more than 50% of patients show a decline in their adherence level within the first year of treatment.

The retrospective cohort analysis conducted by Medco Research Institute® examined the effect statin adherence had on healthcare costs and cardiovascular-related hospitalizations. They analyzed the medical and pharmacy claims records of 381,422 adults age 18-61 years who received statin therapy between January 2007 and June 2009. The average age of the patient population was 53, and 59% were male. Co-morbidities of the study group included high blood pressure (52.1 percent), coronary artery disease (15.2 percent), diabetes (25.4 percent), and depression (8.6 percent).

The analysis confirmed that patients with high cholesterol who remain adherent to their cholesterol-lowering medications have significantly fewer cardiovascular-related hospitalizations and can reduce their healthcare costs. Patients who took their cholesterol medications 90 percent or more of the time had total healthcare costs of $10,162, compared with $11,106 for the group of patients who were poorly adherent, a difference of  $944 over 18 months; which could save billions of healthcare dollars annually.

The study found approximately 1/3 of the 381,422 patients were non-adherent to statins 67.6% were adherent (MPR >80%), 17.3% had an MPR of 60% to 79%, and 15.1% had an MPR of <60%. Non-adherence in the baseline year was associated with a $400 to $900 per patient greater total healthcare cost and increased likelihood of a CVD-related hospitalization in the subsequent 18 months. When evaluated by 5 levels of MPR, 0% to 59% and increments of 10%>60%, the adjusted total healthcare costs were lowest for the MPR 90% to 100% group (p <0.001). In the adherent group, greater statin drug costs were offset by the lower medical costs, leading to lower total healthcare costs. If we extrapolate these findings to the >24 million patients who receive statins in the United States, increasing adherence for the estimated 8 million non-adherent patients would have the potential to improve patient outcomes and save the healthcare system >$3 billion dollars annually.

Findings were published in the June 1 issue of the American Journal of Cardiology.