Suneela Mehta1, Sue Wells2, Rod Jackson3, Jeff Harrison4, Andrew Kerr5. 1. Research Fellow, Section of Epidemiology and Biostatistics, University of Auckland, Auckland. 2. Associate Professor, Section of Epidemiology and Biostatistics, University of Auckland, Auckland. 3. Professor of Epidemiology, Section of Epidemiology and Biostatistics, University of Auckland, Auckland. 4. Senior Lecturer, School of Pharmacy, University of Auckland, Auckland. 5. Clinical Head, Department of Cardiology, Middlemore Hospital, Auckland.
Abstract
AIM: Publicly-funded atorvastatin required prior approval until September 2010 whereas simvastatin did not. Our aim was to examine if overall statin dispensing and atorvastatin dispensing among patients hospitalised for cardiovascular disease (CVD) differed systematically across sociodemographic groups during and after special authority criteria. METHOD: National medication dispensing data were anonymously linked to patients hospitalised across New Zealand with CVD and discharged between 1/07/2009-31/12/2009 when special authority criteria applied and 1/09/2010-28/02/2011 after restrictions ceased. Statin dispensing at least once within six months post-discharge was analysed by sociodemographic characteristics. RESULTS: Overall statin use was the same (80%) among patients discharged during (n=14,094) and after (n=13,274) restrictions. With restrictions, atorvastatin dispensing was 32-33% less frequent among statin-users <45 years and >75 years than 65-74 year olds and 28-55% less among Māori, Pacific and Indian peoples than all others. Minimal relative differences occurred by sex or deprivation status. After restrictions were lifted, the proportion of statin-users dispensed atorvastatin increased around two-fold or more across all sociodemographic strata with three-four fold increases for patients >55 years and for Māori, Pacific and Indian peoples. CONCLUSION: After funding restrictions ceased, disparities in atorvastatin dispensing appeared to reduce across age and ethnic groups among patients with CVD-related hospitalisations, but overall statin use was unchanged.
AIM: Publicly-funded atorvastatin required prior approval until September 2010 whereas simvastatin did not. Our aim was to examine if overall statin dispensing and atorvastatin dispensing among patients hospitalised for cardiovascular disease (CVD) differed systematically across sociodemographic groups during and after special authority criteria. METHOD: National medication dispensing data were anonymously linked to patients hospitalised across New Zealand with CVD and discharged between 1/07/2009-31/12/2009 when special authority criteria applied and 1/09/2010-28/02/2011 after restrictions ceased. Statin dispensing at least once within six months post-discharge was analysed by sociodemographic characteristics. RESULTS: Overall statin use was the same (80%) among patients discharged during (n=14,094) and after (n=13,274) restrictions. With restrictions, atorvastatin dispensing was 32-33% less frequent among statin-users <45 years and >75 years than 65-74 year olds and 28-55% less among Māori, Pacific and Indian peoples than all others. Minimal relative differences occurred by sex or deprivation status. After restrictions were lifted, the proportion of statin-users dispensed atorvastatin increased around two-fold or more across all sociodemographic strata with three-four fold increases for patients >55 years and for Māori, Pacific and Indian peoples. CONCLUSION: After funding restrictions ceased, disparities in atorvastatin dispensing appeared to reduce across age and ethnic groups among patients with CVD-related hospitalisations, but overall statin use was unchanged.