NATIONAL TRENDS IN STATIN AND EZETIMIBE USE AND CARDIOVASCULAR RISK AMONG U.S. ADULTS WITH HYPERLIPIDEMIA: MEPS 2018-2023
Author(s)
Abdulrahman Y. Alharbi, MS1, Fatimah Sherbeny, MS, PharmD, PhD2.
1Florida A&M University, Tallahassee, FL, USA, 2ESAP,COPPS Florida A&M University, Tallahassee, FL, USA.
1Florida A&M University, Tallahassee, FL, USA, 2ESAP,COPPS Florida A&M University, Tallahassee, FL, USA.
OBJECTIVES: Hyperlipidemia is a major modifiable risk factor for cardiovascular disease (CVD), yet real-world utilization patterns of lipid-lowering therapies continue to evolve. This study evaluated national trends in statin and ezetimibe utilization among U.S. adults with hyperlipidemia and examined concurrent changes in cardiovascular comorbidity burden from 2018 to 2023.
METHODS: A retrospective, cross-sectional analysis was conducted using the Medical Expenditure Panel Survey (MEPS) Household, Prescribed Medicines, and Medical Conditions files (2018-2023). The study population included adults, aged 18 years or older, diagnosed with hyperlipidemia. Survey-weighted national estimates were generated to assess trends in utilization of individual statins, ezetimibe, and combination therapy. Sociodemographic characteristics, insurance status, and Charlson Comorbidity Index (CCI) were evaluated over time. Temporal trends were assessed using survey-adjusted statistical tests, with statistical significance defined as p<0.05.
RESULTS: The study included 25,407 unweighted observations, representing approximately 282.5 million U.S. adults with hyperlipidemia. The population remained predominantly older (mean age: ≈65 years), insured, and male across all years. Atorvastatin remained the most utilized statin, increasing from 44% in 2018 to 51% in 2023 (p<0.001). Rosuvastatin demonstrated the most rapid growth, doubling from 10% to 21% (p<0.001), while utilization of simvastatin, pravastatin, and lovastatin declined significantly. Ezetimibe and statin-ezetimibe combination therapy increased modestly over time. Concurrently, the prevalence of myocardial infarction and congestive heart failure declined, and overall comorbidity burden improved, with a significant shift toward lower CCI categories (p=0.008).
CONCLUSIONS: From 2018 to 2023, lipid-lowering therapy in the U.S. shifted toward higher-intensity statins and greater use of adjunctive treatment strategies, accompanied by measurable improvements in cardiovascular comorbidity burden. These findings highlight progress in guideline-directed lipid management and underscore the value of real-world evidence in informing population-level cardiovascular risk reduction and health policy decision-making.
METHODS: A retrospective, cross-sectional analysis was conducted using the Medical Expenditure Panel Survey (MEPS) Household, Prescribed Medicines, and Medical Conditions files (2018-2023). The study population included adults, aged 18 years or older, diagnosed with hyperlipidemia. Survey-weighted national estimates were generated to assess trends in utilization of individual statins, ezetimibe, and combination therapy. Sociodemographic characteristics, insurance status, and Charlson Comorbidity Index (CCI) were evaluated over time. Temporal trends were assessed using survey-adjusted statistical tests, with statistical significance defined as p<0.05.
RESULTS: The study included 25,407 unweighted observations, representing approximately 282.5 million U.S. adults with hyperlipidemia. The population remained predominantly older (mean age: ≈65 years), insured, and male across all years. Atorvastatin remained the most utilized statin, increasing from 44% in 2018 to 51% in 2023 (p<0.001). Rosuvastatin demonstrated the most rapid growth, doubling from 10% to 21% (p<0.001), while utilization of simvastatin, pravastatin, and lovastatin declined significantly. Ezetimibe and statin-ezetimibe combination therapy increased modestly over time. Concurrently, the prevalence of myocardial infarction and congestive heart failure declined, and overall comorbidity burden improved, with a significant shift toward lower CCI categories (p=0.008).
CONCLUSIONS: From 2018 to 2023, lipid-lowering therapy in the U.S. shifted toward higher-intensity statins and greater use of adjunctive treatment strategies, accompanied by measurable improvements in cardiovascular comorbidity burden. These findings highlight progress in guideline-directed lipid management and underscore the value of real-world evidence in informing population-level cardiovascular risk reduction and health policy decision-making.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EPH1
Topic
Epidemiology & Public Health
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory)