Ortiz Nancy, Shehata Jacqueline, Smart Jeremy, Leinwand Brian, Ali Ahan, Katariya Dushyant, Dicklin Mary R, Hsieh Andrew
New Amsterdam Pharma B.V, Aventura, FL, USA.
Trinity Life Sciences, LLC, Waltham, MA, USA.
J Med Econ. 2025 Dec;28(1):1616-1625. doi: 10.1080/13696998.2025.2558314. Epub 2025 Sep 16.
Atherosclerotic cardiovascular disease (ASCVD) imposes considerable clinical and economic burdens. ASCVD prevention seeks to control low-density lipoprotein cholesterol (LDL-C) using statins as first-line treatment. This retrospective US cohort study assessed unmet clinical needs and healthcare resource use among statin users in primary and secondary prevention.
MarketScan administrative claims 2017-2021 were leveraged and linked to laboratory data to identify patients with hypercholesterolemia followed for 2 years. Numbers of statin-treated hypercholesterolemia patients in primary prevention, very high-risk or not very high-risk secondary prevention, and their LDL-C goal achievement, were estimated and inflated to national estimates, along with annualized healthcare resource utilization and costs. Cardiovascular events according to LDL-C goal attainment were also assessed.
Almost 125,000 statin-treated patients did not meet LDL-C goals. Data inflated to US national estimates suggested approximately 72 million (M) patients have hypercholesterolemia: 43 M primary prevention (∼40% above goal), 9.8 M very high-risk secondary prevention (∼78% above goal), and 9.1 M not very high-risk secondary prevention (∼60% above goal) are treated with statins, and 9.5 M are untreated (∼84% above goal). Managing LDL-C to goal was associated with a 50% reduction in the proportion of patients with a cardiovascular event. Patients utilizing high-cost healthcare services and annualized healthcare costs increased from primary to secondary prevention, and from not very high- to very high-risk secondary prevention.
Prevention is an essential component of any effort to improve population health and ultimately reduce spending. While some prevention efforts are cost-saving, some strategies that improve health will increase total spending. Nonetheless, millions of people in the US taking statins do not achieve LDL-C goals, indicating a significant clinical burden among those with, or at risk for, ASCVD, resulting in substantial healthcare resource use and costs.
