Inpatient Pharmacist Wan Fang Hosp, Taipei Medical Univ, Taipei, Taiwan (Republic of China)
Statement of Purpose: Statins are widely prescribed across England for lipid modification. Maximal dose and intensity of statin therapy are recommended by guidelines for prevention of CVD if tolerated. However, statin prescribing patterns in actual practice can be variable. Additionally, existing studies revealed undertreatment with a lower dose of statins. This study aimed to investigate statin prescribing trends in English hospitals from September 2016 to March 2020. From the group of statin prescribing, our objectives were to determine: (a) the trend of statin prescribing, (b) the utilisation distribution of high- and moderate-intensity statin (c) the trend of statin expenditure.
Description of Methods & Materials: Data for this study were obtained from the Natl Health Service Business Services Authority (NHSBSA) platform and organized using Microsoft Excel before analysis with SPSS statistical software. Statistical significance was defined as a p value less than 0.05, and tests such as one-way ANOVA and Pearson correlations were conducted. The trend was assessed using Linear-by-Linear Association (LLA) tests and the univariate generalized linear model. Statin utilization trends were calculated by dividing the total quantities of statins by their defined daily dose (DDD) values, which are international metrics assigned by the World Health Organization (WHO) and linked with the ATC drug classification system.
Data & Results: This study analysed 33,795 statin prescriptions in English hospitals from December 2016 to March 2020. High-intensity statins were the most commonly prescribed, with an increase in proportion from 52% (491/940) to 65% (479/737) over four years; the proportion of moderate-intensity statin prescribing declined from 37% (344/940) to 29% (213/737) within the study period. Atorvastatin was the most commonly prescribed type of statin, accounting for 56% in 2016 and 68% in 2020. With proportions of statin prescribing stratified by intensity and geographic location, high-intensity statin increased, while the use of moderate-intensity statin declined over the years. Atorvastatin utilisation rose by 25% from 1,758 DDDs per month in 2016 to a peak of 2,213 DDDs per month in 2019. Total actual costs of statin prescribed remained stable at roughly £2,000 after a significantly considerable fall from £4,379 in March 2018 to £1,974 in April 2018 (p value < 0.001). Rosuvastatin had the vast majority of impact on total costs by contributing a maximum of around £2,622 in October 2017, whereas there were less than £500 expenditures on this type of statin in April 2018 due to expiry of the patent in December 2017 (p value < 0.001).
Interpretation, Conclusion or Significance: High-intensity statins were the most commonly prescribed and increasingly used over the study period, whereas moderate-intensity statin presented the opposite trend. Overall, the growing prescribing of optimal statin therapy in secondary care over time revealed better compliance with the guideline recommendations. Future research should collect more detailed data to explore potential reasons for these findings and address objectives with a wider and deeper scope. In addition to the data collection, if statin prescribing data can be captured from both primary and secondary settings, it is more likely to discover findings with higher quality and better accuracy, which is also recommended for future research.
Disclosures: We have no conflicts of interest to disclose.
