Abstract 19516: Trends in Non-Statins Utilization and Expenditures Among U.S. Adults With Established Atherosclerotic Cardiovascular Disease: Medical Expenditure Panel Survey 2002-2013
Objectives: The recent AHA/ACC cholesterol guideline updates do not advocate non-statins as first-line agents of choice among patients with established atherosclerotic cardiovascular disease (ASCVD). In this study we aim to quantify annual trends in utilization, cost, and patient cost shares of non-statins in a representative US adult population (age ≥40 years) with ASCVD between 2002 and 2013.
Methods: Data were obtained annually from 2002-2013 using publicly available Medical Expenditure Panel Survey (MEPS) database. Full-year consolidated, medical conditions and prescribed medicines files were used to generate estimates of non-statin utilization, expenditure and payment share. ASCVD diagnoses (coronary artery disease, peripheral artery disease & stroke) were ascertained by ICD-9-CM codes and self-report. All analyses took into account MEPS complex design. Non-statin costs were adjusted to 2013 USD using Gross Domestic Product Index.
Results: As shown in the Table, among 15.2 million US adults with established ASCVD in 2002-2003, 7.5% reported using non-statins, with utilization peaking in 2008-2009 (17.9%) and declining to 13.9% in 2012-2013. The corresponding numbers of prescriptions for these respective cycles were 8.7, 24.6, and 18.4 million. Among those on statins, use of non-statins increased from 9.3% in 2002-2003 to 15.8% in 20012-2013. Among those not on statins, respective rates for non-statins use were 5.7% & 11.5%. The GDP adjusted non-statins costs in 2002-2003 were $0.6 billion, peaked in 2010-2011 ($3.9 billion). Overall patient cost share decreased from 38.6% ($238 million) in 2002-2003 to 18.7% ($638 million) in 2012-2013, with no change in respective average annual out-of-pocket ($208 vs. $207).
Conclusion: One in seven US adults with established ASCVD reported regular use of non-statins despite limited evidence of favorable clinical outcomes, contributing to significant total healthcare and patient financial burden.
Author Disclosures: J.A. Salami: None. H.J. Warraich: None. J. Valero-Elizondo: None. O. Ogunmoroti: None. S.S. Virani: None. R. Blankstein: None. E.S. Spatz: None. N. Desai: None. M.J. Blaha: None. A. Khera: None. R.S. Blumental: None. D. Lloyd-Jones: None. K. Nasir: None.
- © 2016 by American Heart Association, Inc.