Utilization patterns of extended-release niacin in Canada: Analysis of an administrative claims database

Dorais, Marc; Chirovsky, Diana; Ambegaonkar, Baishali; Sazonov, Vasilisa; Davies, Glenn; Grant, Susan; LeLorier, Jacques

doi:10.1016/s0828-282x(10)70413-x

Cited by 12 publications

(8 citation statements)

References 34 publications

(28 reference statements)

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“…Results from this 5-year retrospective administrative claims analysis indicate that persistence with index statin therapy is poor in patients with elevated TG (≥ 150 mg/dL) or high TG (200–499 mg/dL), diabetes, and/or ASCVD. This result is consistent with a number of previous studies over the past two decades, and confirms that poor long-term statin persistence remains an issue of concern for patients with high CV disease risk, including those with elevated TG who may be at increased risk of CV events and patients with diabetes [4–6, 8, 10, 16, 17]. This highlights the fact that very little, if anything, has changed in the last two decades with regard to improving statin persistence, which remains abysmal in all groups probed in our study, all of whom are at high risk of CV events.…”

Section: Discussionsupporting

confidence: 92%

“…However, adherence and persistence to statin therapy are low, and this has been shown to negatively impact clinical outcomes and residual cardiovascular (CV) risk [2, 3]. Nearly a decade ago, statin persistence was reported to be less than 50% after 1 year [4]. A more recent study found that the proportion of days covered with a statin after a median follow-up of 2.2 years was 76%, with 40.5% of patients having poor adherence after 2 years [5].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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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.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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“…Our analyses of the Optum Research Database found that only approximately 20% of patients were still on statin therapy after 5 years, even in those with additional risk factors. This finding is in line with what has been previously reported [39][40][41][42][43]. Shroufi and Powles further estimated that an improvement in adherence from 50 to 75% could cut the number of deaths related to CVD by 200% [44].…”

Section: Discussionsupporting

confidence: 91%

Real-world Analyses of Patients With Elevated Atherosclerotic Cardiovascular Disease Risk From the Optum Research Database

et al. 2020

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More than 56 million Americans have hypertriglyceridemia, including over 12 million statin-treated individuals. However, the contribution of elevated and high triglyceride levels to cardiovascular disease and death has not been extensively studied using real-world analyses. We review recent analyses of the Optum Research Database, which included patients aged ≥45 years with diabetes and/or atherosclerotic cardiovascular disease and on statin therapy. Triglyceride levels ≥150 and 200–499 mg/dl were significantly associated with a 25.8 and 34.9% increased relative risk of cardiovascular events, respectively, versus patients with triglyceride levels <150 mg/dl. In addition, hypertriglyceridemia predicted peripheral arterial revascularization, new heart failure diagnosis and new-onset renal disease. Increased triglyceride levels were also significantly associated with increased healthcare resource utilization and costs. Interventions such as icosapent ethyl reduce triglycerides and associated cardiovascular disease risk.

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“…In a claims database, Catalan and LeLorier [26] showed that in a cohort of patients initiating a statin only 33% were still adherent after 1 year. Dorais et al [27], reported that, among 19,727 patients initiating a statin, 53.3% had discontinued treatment after 1 year. Wouters et al [28] explored the many reasons for statin non-adherence.…”

Section: Discussionmentioning

confidence: 99%

Economic Evaluation of a Pharmacogenomics Test for Statin-Induced Myopathy in Cardiovascular High-Risk Patients Initiating a Statin

et al. 2016

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BackgroundStatins are the mainstay hypercholesterolemia treatment and reduce the risk of cardiovascular events in patients. However, statin therapy is often interrupted in patients experiencing musculoskeletal pain or myopathy, which are common in this patient group. Currently, the standard tests for diagnosing statin myopathies are difficult to interpret. A pharmacogenomics (PGx) test to diagnose statin-induced myopathy would be highly desirable.MethodsWe developed a Markov state model to assess the cost-effectiveness of a hypothetical PGx test, which aims to identify statin-induced myopathy in high-risk, secondary prevention cardiovascular patients. The alternative strategy hypothesized is that physicians or patients interrupt the statin therapy in the presence of musculoskeletal pain. Our model includes health states specific to the PGx test outcome which assesses the impact of test errors.ResultsAssuming a perfect test, the results indicate that the PGx test strategy dominates when the test costs less than CAN$356, when the strategy is cost neutral. These results are robust to deterministic and probabilistic sensitivity analyses.ConclusionOur base-case results show that a PGx test for statin-induced myopathy in a high-risk, secondary prevention of a cardiovascular event population would be a dominant solution for a test cost of CAN$356 or less. Furthermore, the modelling of the complete range of diagnostic test outcomes provide a broader understanding of the economic value of the pharmacogenomics test.

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Utilization patterns of extended-release niacin in Canada: Analysis of an administrative claims database

Cited by 12 publications

References 34 publications

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

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

Real-world Analyses of Patients With Elevated Atherosclerotic Cardiovascular Disease Risk From the Optum Research Database

Economic Evaluation of a Pharmacogenomics Test for Statin-Induced Myopathy in Cardiovascular High-Risk Patients Initiating a Statin

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