Trends in the supply and use of lipid-lowering drugs in Spain, 1983 through 1991.

Trends in the supply and use of lipid-lowering drugs in Spain were studied throughout the period of 1983-1991. Although the supply of such drugs remains excessive, a trend towards more rational standards has been apparent: 20 specialties out of 53 existing in 1983 have been withdrawn (10 fixed-dose combinations and 10 obsolete drugs). The overall use of lipid-lowering drugs rose from 2.51 DDD/1000 inhab/day in 1983 to 8.47 DDD/1000 inhab/day in 1991. The increase was mostly attributable to the subgroup of fibric acid derivatives (1.23 DDD/1000 inhab/day in 1983 and 6.14 in 1991). The bile acid sequestrants accounted for a small fraction of the overall use (0.23 DDD/inhab/day in 1991), in spite of its increasing consumption. The use of the two subgroups, nicotinic acid derivatives and fixed-dose combinations, has declined. The introduction into the market of HMG-CoA reductase inhibitors in 1991 contributed to the increase of the overall use in 1.28 DDD/1000 inhab/day but it seems not to have any negative influence on the use of other subgroups. Although the prevalence rates of hypercholesterolemia are similar, the use of lipid-lowering drugs in 1991 in Spain was 3 to 8 times higher than that of the Nordic countries. In conclusion, our data suggest that lipid-lowering drugs are highly used in Spain, at least in comparison with other western countries, and that the pattern of drug use is not in accordance with international recommendations.