Health Aff (Millwood). 2014 Feb;33(2):273-82. doi: 10.1377/hlthaff.2013.0388.
Statin use has increased substantially in North America and Europe, with resultant reductions in cardiovascular mortality. However, little is known about statin use in lower-income countries. India is of interest because of its burden of cardiovascular disease, the unique nature of its prescription drug market, and the growing globalization of drug sales. We conducted an observational study using IMS Health data for the period February 2006-January 2010. During the period, monthly statin prescriptions increased from 45.8 to 84.1 per 1,000 patients with coronary heart disease-an increase of 0.80 prescriptions per month. The proportion of the Indian population receiving a defined daily statin dose increased from 3.35 percent to 7.78 percent. Nevertheless, only a fraction of those eligible for a statin appeared to receive the therapy, even though there were 259 distinct statin products available to Indian consumers in January 2010. Low rates of statin use in India may reflect problems with access to health care, affordability, underdiagnosis, and cultural beliefs. Because of the growing burden of cardiovascular disease in lower-income countries such as India, there is an urgent need to increase statin use and ensure access to safe products whose use is based on evidence. Policies are needed to expand insurance, increase medications' affordability, educate physicians and patients, and improve regulatory oversight.
他汀类药物的使用在北美和欧洲大幅增加，由此降低了心血管死亡率。然而，对于低收入国家的他汀类药物使用情况知之甚少。印度是一个有趣的研究对象，因为它有心血管疾病的负担，其处方药市场的独特性，以及药品销售的日益全球化。我们利用 IMS Health 公司 2006 年 2 月至 2010 年 1 月的数据进行了一项观察性研究。在此期间，每月冠心病患者的他汀类药物处方量从 45.8 增加到 84.1，每月增加 0.80 张处方。接受特定日剂量他汀类药物的印度人口比例从 3.35%增加到 7.78%。然而，尽管 2010 年 1 月印度消费者有 259 种不同的他汀类药物产品可供选择，但只有一小部分符合他汀类药物治疗条件的人接受了这种治疗。印度他汀类药物使用率低可能反映出医疗保健可及性、可负担性、诊断不足和文化信仰等方面的问题。由于印度等低收入国家心血管疾病负担不断增加，迫切需要增加他汀类药物的使用，并确保安全产品的可及性，这些产品的使用应基于证据。需要制定政策来扩大保险范围、提高药物的可负担性、对医生和患者进行教育，并加强监管监督。
