OBJECTIVES :

Studies have reported that up to one third of patients with a history of arteriosclerotic cardiovascular disease (ASCVD) do not initiate statin treatment, which increase the probability of bad outcomes and cause unnecessary medical care costs. Therefore, this study aims to explore associations between statin therapy and medical outcomes and costs based on real world data in China. In addition, the major factors influencing individual medication adherence were also investigated in the study.

METHODS : We screened 1709 patients with new-onset ASCVD diagnosis from administrative claims database of Fujian province from April 2012 to December 2014. We collected the prescription data on statin, clinical outcomes and medical costs in 1 year. The composite of major adverse cardiovascular events is compared between the patients with and without statin treatment after propensity score matching(PSM). The direct medical cost per patient between two groups were also assessed. In addition, multivariate logistic regression analysis was conducted to investigate the major factors related with medication adherence.

RESULTS : Of 1709 patients, 83.1% of patients received statin therapy. The patients received statin therapy showed significantly lower MACE rate than the patients without receiving statin therapy (16.12% vs 26.03, p < 0.01). In addition, the patients treated with statin saved medical cost significantly per patient comparing with the patients who haven’t been treated with statin(￥14175.57 vs ￥28801.77, P < 0.05). The multivariate logistic regression result indicated that patients with good medication adherence were older, more commonly male, combined with ACS, ischemic stroke, coronary revascularization, concomitant with aspirin, and with a medical history of endocrine, nutritional and metabolic diseases.

CONCLUSIONS : Statin therapy can bring better outcomes and save medical costs for new-set ASCVD patients. Some intervention should be applied to motivate patients to receive statin therapy and keep good medication adherence, hence the health care outcomes could be improved remarkably.