Leon A Simons
Therapy with hydroxymethylglutarylCoA (HMG-CoA) reductase inhibitor drugs, better known as ‘statins’, has become an essential part of cardiovascular disease prevention and therapy.1,2 Yet it is recognised that statin treatment, in conjunction with therapy of other chronic asymptomatic conditions, is associated with unsatisfactory long term persistence.3 In 1996,we reported that 40% of Sydney (New South Wales) residents who had been newly prescribed lipid lowering drugs had discontinued this therapy within 6 months.4 In 1999, we accessed Australia-wide Pharmaceutical Benefits Scheme (PBS) claim records and reported that 30% of patients newly prescribed lipid lowering drugs, mainly statins, had discontinued therapy within 6 months.5 More recently we reported that 35% of Australian patients newly prescribed antihypertensive drugs had also discontinued therapy within 6 months.6
Long term persistence on statin drugs
has been shown to be unsatisfactory,
however, there is little recent Australian
data. This study examines current
persistence Australia-wide in patients
who have been newly prescribed a statin
We conducted a longitudinal assessment
of Pharmaceutical Benefit Scheme claim
records dating from April 2005 to March
2010. Main outcome measures were
the proportion of patients who were
not filling a first repeat prescription at
1 month, and median persistence time
during follow up.
For 77 867 patients initiated to statin,
86% of prescriptions came from general
practitioners. Forty-three percent of
patients discontinued statin within
6 months, 23% failed to collect their
first repeat at 1 month, and median
persistence time was only 11 months.
In those aged 65–74 years, median
persistence time was 19 months but only
3–6 months for those less than 55 years.
Unsatisfactory long term persistence
on statin therapy has changed little
over the past 10 years. There may be
an opportunity for early intervention
within 3–4 weeks of initiation to improve
persistence, as valuable resources are
being wasted and an opportunity for
disease prevention missed.
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