Lipid-lowering drug use in Italian primary care: effects of reimbursement criteria revision |
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Authors: | G Trifirò M Alacqua S Corrao S Moretti D U Tari M Galdo UVEC Group A P Caputi V Arcoraci |
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Institution: | (1) Department of Clinical and Experimental Medicine and Pharmacology, Pharmacology Unit, University of Messina, Via Consolare Valeria-Gazzi, 98125 Messina, Italy;(2) Biomedical Department of Internal Medicine & Subspecialties, University of Palermo, Palermo, Italy;(3) Caserta 1 Local Health Service, Caserta, Italy;(4) IRCCS Centro Neurolesi “Bonino-Pulejo”, Messina, Italy |
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Abstract: | Objective To assess whether the prescribing pattern of lipid-lowering drugs (LLD) changed after reimbursement criteria revision in a
general practice in southern Italy.
Methods From the Caserta-1 Local Health Service database, 93 general practitioners (GPs) who had consistently sent data about their
patients during the years 2003-2005 were recruited. Prevalence of use and incidence of new treatments were calculated for
each year, stratified by three drug cohorts: statins, omega-3 fatty acids, and fibrates. Subanalyses by gender, age, and indication
of use were performed.
Results Overall, 1-year prevalence of LLD use increased from 2003 to 2004. After reimbursement criteria revision (November 2004),
a slight decrease was observed for statins, from 41.1 (95% CI: 39.9–42.2) per 1,000 inhabitants in 2004 to 40.3 (39.2–41.5)
in 2005, while omega-3 utilization fell markedly: 14.6 (13.9–15.3) vs. 5.4 (5.0–5.8). The use of both statins and omega-3
fatty acids was reduced particularly for primary prevention. On the other hand, utilization of statins increased in diabetic
patients and as secondary prevention from 2004 to 2005. Concerning individual molecules, 1-year prevalence of use of any statin
declined from 2004 to 2005, except for rosuvastatin.
Conclusions Revision of reimbursement criteria led to significant changes in the trend in LLD use in general practice in southern Italy:
(1) statin utilization was slightly reduced in 2005, although it increased in certain categories, such as diabetic patients,
and (2) omega-3 fatty acid use was strongly reduced even though a higher use in post-infarction cases was reported. |
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Keywords: | Lipid-lowering drug Statins Omega-3 fatty acids Prevalence of use General practice |
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