Case selection for statins was similar in two Canadian provinces: BC and Ontario.
OBJECTIVE
Though statins are fully reimbursed by the public drug programs for seniors in British Columbia (BC) and Ontario, Canada, population-based rates of statin prescription are markedly higher in Ontario. We aimed to assess whether new statin users in BC and Ontario differ in terms of their risk for future coronary heart disease (CHD) events.


METHODS
We collected information for 1998-2001 on demographics, outpatient prescriptions, physician visits, hospital admissions, and vital status from administrative databases to compare the proportions of new statin users aged 66 years and older who had evidence of an acute coronary syndrome (ACS), chronic CHD, neither ACS nor CHD but diabetes, or none of the above.


RESULTS
Approximately 15% and 20% of BC and Ontario seniors, respectively, had filled a statin prescription by 2001. Among new statin users in the two provinces, virtually identical proportions had evidence of ACS (8%), chronic CHD (25%), and diabetes (14%), for an overall proportion of roughly 50% at high risk for CHD events.


CONCLUSIONS
New statin users in BC and Ontario were at similar risk for future CHD events. Poorer case selection is unlikely to explain the relatively higher rates of statin prescription in Ontario.
Paterson
J Michael
JM
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. paterson@ices.on.ca
Carney
Greg
G
Anderson
Geoffrey M
GM
Bassett
Ken
K
Naglie
Gary
G
Laupacis
Andreas
A
D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D004363:Drug Utilization / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D009864:Ontario / Q000453:epidemiology; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors