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

• Published in: Atherosclerosis Vol. 235; no. 1; pp. 81 - 83
• Main Authors: Cicero, Arrigo F.G., Derosa, Giuseppe, Parini, Angelo, Baronio, Cristina, Borghi, Claudio
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.07.2014
• Subjects: Aged; Cardiovascular; 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; Nutraceuticals; Persistence; Reimbursement; Statin; Persistence; Reimbursement; Statin; Nutraceuticals
• ISSN: 0021-9150; 1879-1484; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2014.04.016

to evaluate the main factors associated with long-term persistence in fully paid lipid-lowering treatment. 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). 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. Among self-paying patients with mild hyperlipidemia, medication persistence is highest among those taking nutraceuticals, followed by brand statins, followed by generic statins. •Long-term persistence on fully paid lipid-lowering treatments is usually low.•We evaluated the predictors of persistence in a large cohort of patients.•Persistence was higher in women, subjects with early CVD, and high LDL-C.•Persistence was higher in subjects treated with lipid-lowering nutraceuticals.•Persistence was unrelated to the treatment cost.