Prescription Fills for High-Intensity Statins Increased from 2011 to 2014

From 2011 to 2014 the use of high-intensity statins following hospitalization for myocardial infarction (MI) increased progressively, according to a study published in Journal of the American College of Cardiology.

Researchers examined trends and predictors of high-intensity statin use following hospital discharge for MI using the MarketScan database for commercial insurance and Medicare for government health insurance. The study included 42,893 MarketScan beneficiaries who were younger than age 65 and 75,096 Medicare beneficiaries between the ages of 66 and 75.

During the study period, the percentage of beneficiaries filling their first high-density statin prescription following hospital discharge of MI increased from 33/5% to 71/5% among the MarketScan group and from 24.8% to 57.5% for the Medicare group.

“Several events occurred during the study period that may have contributed to the changes in high-intensity statin use,” the authors determined.

First, the patent on the statin atorvastatin expired, and by mid-2012 there were less costly generic formulations of atorvastatin becoming available. Second, guidelines from the American Heart Association/American College of Cardiology recommended high-intensity statin use for patients younger than age 75 who had acute coronary syndrome.

The researchers determined that men, those filling beta-blocker and antiplatelet agent prescriptions within 30 days after discharge, and those attending cardiac rehabilitation were more likely to initiate a high-intensity statin versus a low- or moderate-intensity statin.

During this time, fills for atorvastatin increased, while fills for simvastatin or rosuvastatin decreased. The researchers explained that this likely happened because atorvastatin went off patent and because the FDA issued a black box warning against new prescriptions of simvastatin 80 mg because of potential muscle toxicity.

“Despite this favorable trend, a substantial percentage of patients filled low- or moderate-intensity statin prescriptions following hospital discharge for MI in 2014,” the authors wrote. “The present study highlights the need to continue efforts to increase high-intensity statin use following hospital discharge.”