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Trends in Statin Use in Seniors 1999 to 2013: Time Series Analysis

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  • Laura V Minard
  • Amber Corkum
  • Ingrid Sketris
  • Judith Fisher
  • Ying Zhang
  • Ahmed Saleh

Abstract

Purpose: To examine HMG-CoA reductase inhibitor (statin) drug dispensing patterns to Nova Scotia Seniors' Pharmacare program (NSSPP) beneficiaries over a 14-year period in response to: 1) rosuvastatin market entry in 2003, 2) JUPITER trial publication in 2008, and 3) generic atorvastatin availability in 2010. Methods: All NSSPP beneficiaries who redeemed at least one prescription for a statin from April 1, 1999 to March 31, 2013 were included. Aggregated, anonymous monthly prescription counts were extracted by the Nova Scotia Department of Health and Wellness (Nova Scotia, Canada) and changes in dispensing patterns of statins were measured. Data were analyzed using descriptive analyses and interrupted time series methods. Results: The percentage of NSSPP beneficiaries dispensed any statin increased from 5.3% in April 1999 to 20.7% in March 2013. In 1999, most NSSPP beneficiaries were dispensed either simvastatin (29.5%) or atorvastatin (28.7%). When rosuvastatin was added to the NSSPP Formulary in August 2003, prescriptions dispensed for simvastatin, lovastatin, pravastatin, and fluvastatin declined significantly (slope change, -0.0027; 95% confidence interval (CI), (-0.0046, -0.0009)). This significant decline continued following the publication of JUPITER (level change, -0.1974; 95% CI, (-0.2991, -0.0957)) and the availability of generic atorvastatin (level change, -0.2436; 95% CI, (-0.3314, -0.1558)). Atorvastatin was not significantly affected by any of the three interventions, although it maintained an overall decreasing trend. Only upon the availability of generic atorvastatin did the upward trend in rosuvastatin use decrease significantly (slope change, -0.0010, 95% CI, (-0.0015, -0.0005)). Conclusions: The type and rate of statins dispensed to NSSPP beneficiaries changed from 1999 to 2013 in response to the availability of new agents and publication of the JUPITER trial. The overall proportion of NSSPP beneficiaries dispensed a statin increased approximately 4-fold during the study period. In 2013, rosuvastatin was the most commonly dispensed statin (44.1%) followed by atorvastatin (39.1%).

Suggested Citation

  • Laura V Minard & Amber Corkum & Ingrid Sketris & Judith Fisher & Ying Zhang & Ahmed Saleh, 2016. "Trends in Statin Use in Seniors 1999 to 2013: Time Series Analysis," PLOS ONE, Public Library of Science, vol. 11(7), pages 1-15, July.
    • Handle: RePEc:plo:pone00:0158608
    DOI: 10.1371/journal.pone.0158608
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    References listed on IDEAS

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    1. Mariana Carrera & Dana P. Goldman & Geoffrey Joyce & Neeraj Sood, 2018. "Do Physicians Respond to the Costs and Cost-Sensitivity of Their Patients?," American Economic Journal: Economic Policy, American Economic Association, vol. 10(1), pages 113-152, February.
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    3. Sylvain Pichetti & Catherine Sermet & Brian Godman & Stephen Campbell & Lars Gustafsson, 2013. "Multilevel Analysis of the Influence of Patients’ and General Practitioners’ Characteristics on Patented Versus Multiple-Sourced Statin Prescribing in France," Applied Health Economics and Health Policy, Springer, vol. 11(3), pages 205-218, June.
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