The use of Statins in General Practice Evidence based

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The use of Statins in General Practice - Evidence
based?

• Keith Farrar
• School of Pharmacy Chemistry
• Liverpool John Moores University

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Background

• Major outcome trials 94-96, SMAC 97, NSF 2000
  all promoted use of statins
• Spend on CHD drugs increased by 23 to 1,158
  million from 1998 to 1999
• Spend on lipid-regulating drugs increased by 66
  million (35) with 33 increase in prescription
  numbers

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Data Source

• Data obtained from Doctors Independent Network,
  Din-Link
• Din-Link data is longitudinal patient data that
  shows actual dose prescribed
• Data is taken from a panel of 100 GP practices,
  comprising approximately 900,000 patients and 370
  doctors
• Total of 243,517 prescriptions in 14, 329
  patients from 01/93 to 12/98 analysed

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No patients in treatment - lipid lowering drugs
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Market share (patients) by class
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Market share - statins
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Percentage breakdown of use by dose
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Percentage breakdown of use by dose
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Percentage breakdown of use by dose
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Percentage breakdown of use by dose
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Percentage breakdown of use by dose
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Statin prices (BNF)
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Main Points

• SMAC guidelines and later the NSF on CHD promoted
  the use of statins to reduce risk of CHD
  mortality
• Spend on statins is significant
• The majority of prescriptions are for lower doses
  than were used in the large outcome studies
• We may not be getting the health gain we require
  from the investment we make