Long-term statin persistence is poor among high-risk patients with dyslipidemia: a real-world administrative claims analysis

• Main Authors: Peter P. Toth, Craig Granowitz, Michael Hull, Amy Anderson, Sephy Philip
• Format: Article
• Language: English
• Published: BMC 2019-09-01
• Series: Lipids in Health and Disease
• Subjects: Statin; Triglycerides; Persistence; Discontinuation; Atherosclerotic cardiovascular disease; Diabetes
• Online Access: http://link.springer.com/article/10.1186/s12944-019-1099-z

Abstract Background A decade ago, statin persistence was < 50% after 1 year, and recent short-term analyses have revealed very little progress in improving statin persistence, even in patients with a prior cardiovascular (CV) event. Data on longer-term statin persistence are lacking. We measured long-term statin persistence in patients with high CV risk. Methods This retrospective administrative claims analysis of the Optum Research Database included patients aged ≥ 45 years with diabetes and/or atherosclerotic CV disease (ASCVD) who had a statin prescription filled in 2010. It included an elevated triglycerides (TG) cohort of patients with index date in 2010 and TG ≥ 150 mg/dL (n = 23,181) and a propensity-matched comparator cohort with TG < 150 mg/dL and high-density lipoprotein cholesterol > 40 mg/dL (n = 23,181). Both cohorts were followed for ≥ 6 months up to March 2016. Results The probability of remaining on a prescription fill for index statin therapy was 47% after 1 year and 19% after 5 years in both cohorts. Statin persistence was worse among women than men, and among younger versus older patients (P < 0.001 for all comparisons). After 5 years, the probability of remaining on a prescription fill for index statin was < 25% across all subgroups assessed including patients with and without baseline revascularization, heart failure, peripheral artery disease and renal disease. Similar results were observed in a subcohort analysis of patients with TG 200–499 mg/dL. Conclusions Long-term statin persistence after 5 years is alarmingly low (< 25%) and is a public health concern.