Preventive cardiologyAdherence to Statins, Subsequent Healthcare Costs, and Cardiovascular Hospitalizations
Section snippets
Methods
The source of data was the Medco National Integrated database, which contains 30 months of medical and pharmacy claims data for approximately 13 million patients enrolled in >450 different health plans, including fee-for-service, preferred provider, and managed care plans sponsored by insurance companies, employers, and government organizations. The medical claims contain all inpatient, outpatient, nursing home, laboratory, and diagnostic testing claims the health plan has received. The
Results
Our analysis identified 381,422 patients who met the inclusion criteria. The patient demographics are listed in Table 1. The mean level of adherence in year 1 was 43.1% in the MPR <60% group, 71.3% in the 60% to 79% adherence group, and 94.5% in the MPR ≥80% adherent group.
Overall, the most common co-morbidities were hypertension, coronary artery disease, and diabetes mellitus. Also, 8.6% of the patients had a history of depression. The adherent group was older, more likely to be men, and had a
Discussion
The objective of the present study was to evaluate whether adherence to statins for 12 months was associated with the subsequent healthcare costs and CVD-related hospitalizations. In the present large, national sample of insured patients receiving statins, we found approximately 1/3 of the 381,422 patients were nonadherent to statins in the baseline year and that nonadherence was associated with a $400 to $900 per patient greater total healthcare cost and increased likelihood of a CVD-related
Acknowledgment
We thank Lorraine Tully, RHIT (Medco Health Solutions), for assistance with medical coding; Ray Brown, BSPharm (Medco Health Solutions), for analytic contributions; and Diane Graul (Medco Health Solutions) for administrative support. We thank Steven Haffner, MD and Cindy Fenton, MD (Medco Health Solutions Consultants), for assistance with all study phases.
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