Almost Half of People Eligible for Statins Do Not Take Them

Only 42 percent of the 26.8 million adults for whom statins are recommended to prevent heart disease take them, according to a new study from AHRQ staff researchers. Rates of statin use have remained flat in the last decade, despite evidence that statins reduce death from heart disease, the leading cause of death among adults age 40 and older. In 2016, the U.S. Preventive Services Task Force (USPSTF) released new recommendations on statin use to prevent heart disease. Researchers used data from the Agency’s Medical Expenditure Panel Survey to assess the size and characteristics of the population that meet the USPSTF criteria for statin use. They also calculated the number of statin prescriptions filled, as well as out-of-pocket and total costs. Among adults recommended for statin use, women, Hispanics, and people living in the South or without health insurance were less likely to take the drugs. The USPSTF recommendations may result in decreased out-of-pocket costs and expanded access to statins, according to researchers. However, future research is needed to determine if eliminating copayments increases adherence and lowers rates of heart attacks and strokes. Access the abstract.

2018 May 31. doi: 10.1007/s11606-018-4497-4. [Epub ahead of print]

Estimated Impact of US Preventive Services Task Force Recommendations on Use and Cost of Statins for Cardiovascular Disease Prevention.

Ngo-Metzger Q1, Zuvekas SH2, Bierman AS2.

Author information

Abstract

BACKGROUND:

US Preventive Services Task Force (USPSTF) released new recommendations on statin use for atherosclerotic cardiovascular disease (ASCVD) prevention. The Affordable Care Act (ACA) mandates USPSTF recommendations with an "A" or "B" grade receive insurance coverage without copayment. We assessed the potential impact of these recommendations.

OBJECTIVE:

To assess the US population meeting criteria for statin use and factors associated with use, and calculate associated costs.

DESIGN AND MEASURES:

We estimated 10-year ASCVD event risk scores from National Health and Nutrition Examination Survey data using Pooled Cohort Equations from the American College of Cardiology/American Heart Association and applied them to Medical Expenditure Panel Survey data. We estimated the population meeting USPSTF criteria and calculated the number of statin prescription fills and out-of-pocket and total costs. We assessed associations between statin use and sociodemographic and health characteristics and national trends in use from 1996 to 2014.

PARTICIPANTS:

A nationally representative sample of people aged ≥ 40 years, representing 150 million people living in the USA.

KEY RESULTS:

Of 26.8 million adults recommended for statins, only 41.8% were taking them. Female sex, Hispanic ethnicity, uninsured status, or living in the South was associated with lower odds of using statins. Under ACA, people with private insurance would avoid out-of-pocket cost of $9 for each generic prescription, resulting in savings of approximately $44 in annual costs. ACA's mandate for insurance coverage would result in a $193 million shift in out-of-pocket cost for statins from patients to private insurers.

CONCLUSIONS:

New USPSTF recommendations may result in decreased out-of-pocket costs and expanded access to statins. Previous research has shown that eliminating copayments increased adherence and decreased rates of ASCVD events without increasing overall healthcare costs. Future research will determine whether the USPSTF's recommendations will result in similar findings.