OBJECTIVES

Drug survival (time to drug discontinuation) is a comprehensive indicator reflecting long-term drug performance and patient preferences in the real world. The purpose of this study is to evaluate the survival time of lipid-lowering drugs in dyslipidemia patients and the effect of drug safety concerned on drug survival.

METHODS

We used treatment journey data collected for market research to retrospectively study drug safety concerned among patients treated lipid-lowering for dyslipidemia (2000-2018). Drug survival was defined as the time from drug initiation to discontinuation(stop/switch). Patients were classified into two groups: (1)the safe group, defined as the patients who believed the drug’s safety levels were intermediate to high; (2)the unsafe group, defined as the patients who considered the drug’s safety levels were low, or unsure or don’t care about drug safety. Crude drug retention rates were explored using Kaplan-Meier analyses. The hazard ratio(HR) of drug discontinuation was assessed using Cox proportional hazard regression models adjusted for covariates, including but not limited to age, insurance, disease duration, and medication history.

RESULTS

A total of 358 prescription-treated patients with dyslipidemia were identified. Compared with the safe group(n=102), the unsafe group(n=256) was more likely to be less educated(below university degree), currently smoke, have shorter disease duration(<5 years) and medication history. The crude 5-year and 10-year drug retention rates were 59% and 43% in safe group, and 40% and 34% in unsafe group(log-rank P=0.02). The median overall drug survival for safe and unsafe group was 8.5 and 3.0 years, respectively. The safe group had a 13% lower chance of discontinuation than unsafe group(HR=0.87 95%CI 0.63-1.20; P=0.05). Age, disease duration and non-medication history were significantly associated with better drug survival.

CONCLUSIONS

Patients who are drug safety concerned and safety literacy show adherence of long-term(>5 years) drug survival. These findings suggest further research into factors influencing safety concerned and literacy.