PharmacoEconomics - Italian Research Articles 2005; 7 (3): 187-194 1590-9158/05/0003-0187/$31.00/0 © 2005 Adis Data Information BV.Tutti i diritti riservati. Dieci anni di utilizzo delle statine: adesione alla terapia e costi del trattamento farmacologico P. Deambrosis, 1 C. Saramin, 1 G. Terrazzani, 1 E. Scaldaferri, 2 P. Giusti, 3 A.Chinellato 1 1 Servizio Farmaceutico Territoriale, Azienda Ulss 9, Treviso 2 U.O.A. Malattie del Metabolismo e Diabetologia (CAD), Azienda Ulss 9, Treviso 3 Dipartimento di Farmacologia, Università degli Studi di Padova, Padova Ten years of statins utilization: adherence to therapy and costs of treatment Objectives: The beneficial effect of lipid-lowering drugs, in particular of HMG- CoA Reductase Inhibitors (statins), is well established. However, their utilization is often believed to be too low. Our objective was to describe consumption and costs and to investigate compliance with statins treatment in an Italian population. Design, Setting, and Patients: A retrospective cohort study conducted on the Local Health Authority N. 9, Treviso, of statin utilization between 1994 and 2003. For the year 2002, were also assessed patients adherence to prescribed treatments and statins efficacy in lipid lowering. Methods: Demographic and pharmaceutical data were retrieved from the database of pharmaceutical prescriptions and from patients’ registry of the Pharmaceutical Office, Local Health Authority N. 9, Treviso. Patients were stratified in cohorts according to incidence year and first statin prescribed. Prescribed Daily Dose (PDD) was calculated for each statin in order to assess the adherence to the therapy of the patients. Cholesterol data at the beginning of treatment and after 3 months were supplied from the database of laboratory tests of Treviso Hospital. Results: In Treviso, the annual spending increased from € 600.000 to about € 4 millions from 1994 to 2003. The PDD in 2002 was 19.8mg for simvastatin, 26.6mg for pravastatin, 66.6mg for fluvastatin, and 13.9mg for atorvastatin. Adherence to therapy was calculated for 1235 patients; we considered non- adherent when less than 50% of statin was prescribed, partially adherent when this percentage rose from 50% to 80% of prescribed drug and adherent when it was at least 80%. According to these criteria, only 42% of incident patients in 2002 was adherent, and only 1/2 of the total statins spending in Treviso was due to adherent patients. In a sample of incidence and adherent patients in 2002 we found a PDD higher than the PDD calculated for all incident patients of that year; patients allocated to fluvastatin seem to have the greatest reduction of total cholesterol (−27.3%). Conclusions: Statins spending has increased dramatically in Treviso in a decade, however statin utilization in a large proportion of patients (non-adherent or partially adherent) is far from being optimal, preventing the potential benefit of the pharmacological treatment. Summary