Dyslipidemia | Treatment Algorithms | Claims Data Analysis | US | 2014

Tens of millions of people in the United States have a lipid abnormality or dyslipidemia. Given the inherent risk of cardiovascular disease that dyslipidemias carry, multiple prescription therapies are available for modifying lipid levels. The 2002 National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III guidelines recommend the use of statins (i.e., HMG-CoA reductase inhibitors) as the primary first-line treatment for the majority of patients with dyslipidemia, on top of lifestyle modifications. The aim of treatment is to reach target lipid levels. If these targets cannot be achieved, or the patient has a particular lipid abnormality, other therapies such as bile acid sequestrants, fibrates, cholesterol absorption inhibitors, niacin derivatives, and omega-3-acid ethyl esters can be used. The American Heart Association and the American College of Cardiology released new guidelines for the treatment of blood cholesterol in November 2013 that support the essence of the 2002 guidelines but highlight that there is little strong evidence to support the targeting of specific lipid levels or the use of any treatment other than statins. Using national patient-level claims data, this report analyzes physician adherence to the treatment guidelines by exploring the use of key therapies in the newly diagnosed and recently treated dyslipidemia patient populations. Among the newly diagnosed patients, the report provides a quantitative analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. Among recently treated patients, the report quantifies a drug’s source of business compared with its competitors and details which drugs precede others through an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.