Prevalence of cardiovascular comorbidities and utilization of evidence-based treatment strategies among statin users in a Medicare and commercial health plan

Background: Although statins are widely used for the prevention and management of cardiovascular disease in patients with dyslipidemia, the prevalence of cardiovascular comorbidities among statin users has not been well studied. Objective: To assess the prevalence of cardiovascular comorbidities, use of concomitant medications, interventions for managing the comorbidities, and hospitalization rates among statin users in Medicare and commercial health plan populations in the United States. Research design and methods: This retrospective study assessed pharmacy and medical claims of Medicare and commercial health plan members between 4/1/2005 and 3/31/2006. Patients with at least one claim for a statin were included in the analyses. Comorbidities and procedures were identified based on the presence of at least one diagnosis or procedure code. Results: Of the continuously eligible 238 900 Medicare and 3 258 266 commercial health plan members, 51 818 (21.7%) and 285 820 (8.8%) were statin users. Among the Medicare and commercial statin users, 62.4% and 41.8% were classified with either coronary heart disease (CHD), angina, diabetes mellitus, stroke, transient ischemic attack, or chronic kidney disease. Only 9.2% of Medicare and 29.2% of commercial statin users were not classified with hypertension or any of the comorbidities listed above. Of those with diabetes mellitus, 28.1% of Medicare and 15.9% of commercial statin users appeared to have received no pharmacotherapy for this condition. During the study period, 20.3% of Medicare and 10.3% of commercial statin users were reported to be hospitalized; 24.1% and 30.0% were admitted due to CHD/angina. Limitations: The study design was descriptive in nature and did not allow for demonstration of cause and effect between diagnoses, treatments, and outcomes. Conclusions: This study highlights that statin users have a high frequency of cardiovascular comorbidities and are at high risk for cardiovascular events. Comorbidity-related hospitalizations are common, yet interventions for managing many of these comorbidities may be underutilized.