Skip to main navigation menu Skip to main content Skip to site footer
##common.pageHeaderLogo.altText##

Original article

Vol. 151 No. 3536 (2021)

Utilisation patterns and costs of lipid-lowering drugs in Switzerland 2013–2019

  • Daphne Reinau 
  • Nadine Schur
  • Sibylle Twerenbold 
  • Eva Blozik 
  • Mathias Früh
  • Andri Signorell
  • Matthias Schwenkglenks 
  • Christoph R. Meier
DOI
https://doi.org/10.4414/SMW.2021.w30018
Cite this as:
Swiss Med Wkly. 2021;151:w30018
Published
01.09.2021

Summary

OBJECTIVE: To analyse utilisation patterns of lipid-lowering drugs and the related costs in Switzerland between the years 2013 and 2019.

METHODS: We conducted a retrospective descriptive study using administrative claims data of persons aged ≥18 years enrolled with the health insurance company Helsana. To enable statements at the Swiss population level, results were extrapolated according to age, sex and canton of residence.

RESULTS: The overall prevalence of patients taking lipid-lowering drugs rose from 8.9% (n = 736,174) in 2013 to 11.6% (n = 841,682) in 2019, but varied markedly across regions, with highest values in Ticino and lowest values in Zurich. More than every third individual aged ≥65 years was treated with a lipid-lowering drug in 2019. Statins were by far the most commonly used drugs (>90% of prescriptions), followed by ezetimibe, fibrates and PCSK9 inhibitors. We observed a trend towards the prescription of more potent statins (atorvastatin, rosuvastatin) in recent years. Total costs of lipid-lowering drugs increased from CHF 222 million in 2013 to CHF 230 million in 2019 (+3.5%), whereas annual per capita costs decreased from CHF 302 in 2013 to CHF 273 in 2019 (−9.4%).

CONCLUSION: The increasing use of lipid-lowering drugs reflects current therapeutic guidelines, but results in high costs for the healthcare system.

References

  1. Swiss Federal Statistical Office. 2017. Causes of deaths statistics 2017 (available from https://www.bfs.admin.ch/bfs/en/home/news/whats-new.assetdetail.11227248.html [accessed on 23 October 2020]).
  2. Swiss Federal Statistical Office. 2017. Specific causes of death (available from https://www.bfs.admin.ch/bfs/en/home/statistics/health/state-health/mortality-causes-death/specific.html [accessed on 23 October 2020]).
  3. Timmis A, Townsend N, Gale CP, Torbica A, Lettino M, Petersen SE, et al.; European Society of Cardiology. European Society of Cardiology: Cardiovascular Disease Statistics 2019. Eur Heart J. 2020 Jan;41(1):12–85. https://doi.org/10.1093/eurheartj/ehz859
  4. Ference BA, Ginsberg HN, Graham I, Ray KK, Packard CJ, Bruckert E, et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease. 1. Evidence from genetic, epidemiologic, and clinical studies. A consensus statement from the European Atherosclerosis Society Consensus Panel. Eur Heart J. 2017 Aug;38(32):2459–72. https://doi.org/10.1093/eurheartj/ehx144
  5. Mach F, Baigent C, Catapano AL, Koskinas KC, Casula M, Badimon L, et al.; ESC Scientific Document Group. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J. 2020 Jan;41(1):111–88. https://doi.org/10.1093/eurheartj/ehz455
  6. Grundy SM, Stone NJ, Bailey AL, Beam C, Birtcher KK, Blumenthal RS, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA Guideline on the Management of Blood Cholesterol: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2019 Jun;73(24):3168–209. https://doi.org/10.1016/j.jacc.2018.11.002
  7. Swiss DRG AG. Fallpauschalen-Katalog SwissDRG-Version 9.0 Abrechnungsversion (2020/2020) (available from: https://www.swissdrg.org/application/files/2615/7650/6488/SwissDRG-Version_9.0_Fallpauschalenkatalog_AV_2020_2020.pdf [accessed on 2 July 2020]).
  8. Gemeinsame Einrichtung KVG. Statistics (available from https://www.kvg.org/de/statistik-_content---1--1052.html [accessed on 18 November 2020]).
  9. Vancheri F, Backlund L, Strender LE, Godman B, Wettermark B. Time trends in statin utilisation and coronary mortality in Western European countries. BMJ Open. 2016 Mar;6(3):e010500. https://doi.org/10.1136/bmjopen-2015-010500
  10. Ofori-Asenso R, Ilomäki J, Zomer E, Curtis AJ, Zoungas S, Liew D. A 10-Year Trend in Statin Use Among Older Adults in Australia: an Analysis Using National Pharmacy Claims Data. Cardiovasc Drugs Ther. 2018 Jun;32(3):265–72. https://doi.org/10.1007/s10557-018-6794-x
  11. O’Keeffe AG, Nazareth I, Petersen I. Time trends in the prescription of statins for the primary prevention of cardiovascular disease in the United Kingdom: a cohort study using The Health Improvement Network primary care data. Clin Epidemiol. 2016 May;8:123–32. https://doi.org/10.2147/CLEP.S104258
  12. Mortensen MB, Falk E, Schmidt M. Twenty-Year Nationwide Trends in Statin Utilization and Expenditure in Denmark. Circ Cardiovasc Qual Outcomes. 2017 Jul;10(7):e003811. https://doi.org/10.1161/CIRCOUTCOMES.117.003811
  13. Knopf HC, Busch MA, Du Y, Truthmann J, Schienkiewitz A, Scheidt-Nave C. [Changes in the prevalence of statin use in Germany - findings from national health interview and examination surveys 1997-1999 and 2008-2011]. Z Evid Fortbild Qual Gesundhwes. 2017 May;122:22–31. https://doi.org/10.1016/j.zefq.2017.04.001
  14. Gu Q, Paulose-Ram R, Burt VL, Kit BK. Prescription cholesterol-lowering medication use in adults aged 40 and over: united States, 2003-2012. NCHS Data Brief. 2014 Dec;(177):1–8.
  15. Salami JA, Warraich H, Valero-Elizondo J, Spatz ES, Desai NR, Rana JS, et al. National Trends in Statin Use and Expenditures in the US Adult Population From 2002 to 2013: Insights From the Medical Expenditure Panel Survey. JAMA Cardiol. 2017 Jan;2(1):56–65. https://doi.org/10.1001/jamacardio.2016.4700
  16. Byrne P, Cullinan J, Murphy C, Smith SM. Cross-sectional analysis of the prevalence and predictors of statin utilisation in Ireland with a focus on primary prevention of cardiovascular disease. BMJ Open. 2018 Feb;8(2):e018524. https://doi.org/10.1136/bmjopen-2017-018524
  17. Rodriguez F, Olufade TO, Ramey DR, Friedman HS, Navaratnam P, Heithoff K, et al. Gender Disparities in Lipid-Lowering Therapy in Cardiovascular Disease: Insights from a Managed Care Population. J Womens Health (Larchmt). 2016 Jul;25(7):697–706. https://doi.org/10.1089/jwh.2015.5282
  18. Reiner Ž, De Backer G, Fras Z, Kotseva K, Tokgözoglu L, Wood D, et al.; EUROASPIRE Investigators. Lipid lowering drug therapy in patients with coronary heart disease from 24 European countries—findings from the EUROASPIRE IV survey. Atherosclerosis. 2016 Mar;246:243–50. https://doi.org/10.1016/j.atherosclerosis.2016.01.018
  19. Appelman Y, van Rijn BB, Ten Haaf ME, Boersma E, Peters SA. Sex differences in cardiovascular risk factors and disease prevention. Atherosclerosis. 2015 Jul;241(1):211–8. https://doi.org/10.1016/j.atherosclerosis.2015.01.027
  20. Mosca L, Barrett-Connor E, Wenger NK. Sex/gender differences in cardiovascular disease prevention: what a difference a decade makes. Circulation. 2011 Nov;124(19):2145–54. https://doi.org/10.1161/CIRCULATIONAHA.110.968792
  21. Lee MT, Mahtta D, Ramsey DJ, Liu J, Misra A, Nasir K, et al. Sex-Related Disparities in Cardiovascular Health Care Among Patients With Premature Atherosclerotic Cardiovascular Disease. JAMA Cardiol. 2021 Jul;6(7):782–90. https://doi.org/10.1001/jamacardio.2021.0683
  22. Karalis DG, Wild RA, Maki KC, Gaskins R, Jacobson TA, Sponseller CA, et al. Gender differences in side effects and attitudes regarding statin use in the Understanding Statin Use in America and Gaps in Patient Education (USAGE) study. J Clin Lipidol. 2016 Jul-Aug;10(4):833–41. https://doi.org/10.1016/j.jacl.2016.02.016
  23. Cholesterol Treatment Trialists’ Collaboration. Efficacy and safety of statin therapy in older people: a meta-analysis of individual participant data from 28 randomised controlled trials. Lancet. 2019 Feb;393(10170):407–15. https://doi.org/10.1016/S0140-6736(18)31942-1
  24. Marques-Vidal P, Paccaud F. Regional differences in self-reported screening, prevalence and management of cardiovascular risk factors in Switzerland. BMC Public Health. 2012 Mar;12(1):246. https://doi.org/10.1186/1471-2458-12-246
  25. Reiner Z, Catapano AL, De Backer G, Graham I, Taskinen MR, Wiklund O, et al.; European Association for Cardiovascular Prevention & Rehabilitation; ESC Committee for Practice Guidelines (CPG) 2008-2010 and 2010-2012 Committees. ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2011 Jul;32(14):1769–818. https://doi.org/10.1093/eurheartj/ehr158
  26. Catapano AL, Graham I, De Backer G, Wiklund O, Chapman MJ, Drexel H, et al.; ESC Scientific Document Group. 2016 ESC/EAS Guidelines for the Management of Dyslipidaemias. Eur Heart J. 2016 Oct;37(39):2999–3058. https://doi.org/10.1093/eurheartj/ehw272
  27. Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, et al.; IMPROVE-IT Investigators. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med. 2015 Jun;372(25):2387–97. https://doi.org/10.1056/NEJMoa1410489
  28. Rachamin Y, Meier R, Rosemann T, Langenegger S, Markun S. Statin treatment and LDL target value achievement in Swiss general practice - a retrospective observational study. Swiss Med Wkly. 2020 May;150:w20244.
  29. Stroes ES, Thompson PD, Corsini A, Vladutiu GD, Raal FJ, Ray KK, et al.; European Atherosclerosis Society Consensus Panel. Statin-associated muscle symptoms: impact on statin therapy-European Atherosclerosis Society Consensus Panel Statement on Assessment, Aetiology and Management. Eur Heart J. 2015 May;36(17):1012–22. https://doi.org/10.1093/eurheartj/ehv043
  30. Swiss Federal Office of Public Health. Spezialitätenliste 2020 (available from http://www.spezialitätenliste.ch [accessed on 18 November 2020]).

Most read articles by the same author(s)