OBJECTIVES: Statins and other lipid-lowering therapies (LLTs) are used to control elevated LDL cholesterol levels and reduce risks of cardiovascular disease (CVD). This study documents the duration of drug therapy achieved during all treatment episodes initiated by patients and estimates how duration of drug therapy impact the risk of CVD events.

METHODS: A retrospective database was created from medical and pharmacy claims covering Jan 1, 2007 to Dec 1, 2017. LLT drug claims were summarized into episodes. An episode was defined when each time a patient initiated treatment, restarted a previously used LLT or switching to a new LLT. Patients were required to have at least 1 year of pre-index and 2 years post-index enrollment data. Drug therapy outcomes included episode duration, MPR, time to and type of subsequent episodes. Clinical outcomes included time to CVD events and all-cause health costs, measured over the 2 years following the index date.

RESULTS: Our test sample was drawn form a 1% sample from the overall database. 53% of LTT episode were for primary prevention and 47% were secondary prevention. 54% of patients were female. At index, the mean age was 58 years and the mean LDL was 142 mg/L. Patients had a mean episode duration of 383 days, and only 30% had a 12-month MPR>=80%. 20% of patients had only one episode, 59% restarted their initial therapy, 20% switched therapies, and 2% initiated an augmentation episode. Average time to restart and switch was 124 and 493 days, respectively. 58% patients had a post-index CVD diagnosis and 27% had a post-index hospitalization. Time to CVD diagnosis and hospitalization was on average 556 and 868 days, respectively. Mean of 2-year total health care cost was $10714.

CONCLUSIONS: LLT compliance remains suboptimal and early treatment termination is common. Further analyses need to be done on subsequent episodes.