title: Rapid increase in statins newly dispensed to Ontario seniors between 1994 and 2000.
abstract: BACKGROUND
  The Ontario government spent approximately 10% (CDN $148 million) of the provincial medication budget on statins in 1998. This number can be expected to grow in light of new guidelines from the United States recommending that three times as many patients should be receiving antihyperlipidemic therapy. There is scant population-based information on the age and sex distributions of patients receiving these medications.
  
  
  OBJECTIVE
  To estimate the rates of new use of statin medications among community-dwelling elderly adults in Ontario between 1994 and 2000.
  
  
  METHODS
  Data from the Ontario Drug Benefit program were used on all medications dispensed to noninstitutionalized Ontarians over 65 years of age to estimate age- and sex-specific annual rates of patients newly dispensed a statin. Changes in rates were estimated using Poisson regression.
  
  
  RESULTS
  The number of elderly Ontarians newly dispensed a statin increased rapidly between 1994 and 2000, with age-standardized rates rising from approximately 840 to 2600/100,000 women and from 810 to about 3100/100,000 men. The highest rates of new use were observed among patients of both sexes aged 65 to 74 years. However, the rate of change increased with advancing age so that the biggest increase was observed among those aged 85 years and above, among whom there was an 8.5-fold increase among women and a 12-fold increase among men.
  
  
  CONCLUSIONS
  Statins have been shown to be safe, efficacious and cost effective in reducing the risk of sudden cardiac death and other acute coronary events among middle-aged patients with pre-existing cardiovascular disease. The present study showed that there was a rapid increase in the rate of statins newly dispensed to elderly patients in Ontario, among whom estimates of safety, efficacy and cost effectiveness are not well quantified. Better estimates of these parameters in the elderly are required because of the high costs and benefits and potential unintended beneficial and harmful effects of statins.
authors.affiliation: Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Vancouver, British Columbia, Canada. alevy@cheos.ubc.ca
authors.forename: Adrian R
authors.initials: AR
authors.lastname: Levy
authors.forename: Bernie J
authors.initials: BJ
authors.lastname: O'Brien
authors.forename: Ed
authors.initials: E
authors.lastname: McMullen
authors.forename: Frank W
authors.initials: FW
authors.lastname: May
authors.forename: Catherine
authors.initials: C
authors.lastname: Demers
authors.forename: Deborah
authors.initials: D
authors.lastname: Marshall
authors.forename: Stuart
authors.initials: S
authors.lastname: MacLeod
mesh_terms: D000368:Aged; D003327:Coronary Disease / Q000191:economics / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004363:Drug Utilization / Q000639:trends; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D009864:Ontario
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents