Factors associated with 2-year persistence in fully non reimbursed lipid-lowering treatments

Atherosclerosis. 2014 Jul;235(1):81-3. doi: 10.1016/j.atherosclerosis.2014.04.016. Epub 2014 Apr 26.

Abstract

Objective: to evaluate the main factors associated with long-term persistence in fully paid lipid-lowering treatment.

Methods: We selected 628 moderately hypercholesterolemic subjects (M: 307; F: 311, mean age 59 ± 9 years old), to whom we firstly prescribed a statin (N. 397) or different kinds of lipid-lowering nutraceuticals (N. 231). Then, depending on their will, patients took brand statin (N. 194) or generic statins (N. 203).

Results: The main determinants of long-term persistence in therapy are female sex (OR 1.21, 95%CI 1.08-1.42), family history of early cardiovascular disease (OR 1.31, 95%CI 1.13-1.49), baseline LDL-C (OR 1.19, 95%CI 1.02-1.33) and treatment with nutraceuticals versus statins (OR 1.29, 95%CI 1.14-1.38). Persistence appears not to be influenced by patient's age, smoking habit, adverse events during treatment, and estimated cardiovascular risk.

Conclusion: Among self-paying patients with mild hyperlipidemia, medication persistence is highest among those taking nutraceuticals, followed by brand statins, followed by generic statins.

Keywords: Nutraceuticals; Persistence; Reimbursement; Statin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiovascular Diseases / drug therapy*
  • Cardiovascular Diseases / prevention & control
  • Cohort Studies
  • Dietary Supplements
  • Drugs, Generic
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / economics
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / drug therapy*
  • Insurance, Pharmaceutical Services
  • Lipids / blood
  • Male
  • Medication Adherence*
  • Middle Aged
  • Multivariate Analysis

Substances

  • Drugs, Generic
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Lipids