title: Is there a relationship between early statin compliance and a reduction in healthcare utilization?
abstract: OBJECTIVE
  To investigate whether compliance during the first 2 years of statin therapy is associated with reduced hospitalization rates and direct medical costs during year 3.
  
  
  METHODS
  An integrated pharmacy and medical claims database was used to identify adult patients with a new statin prescription between July 1, 2001, and June 30, 2002. The study tracked statin prescription refills during the first 2 years after the initial statin claim and tracked hospitalizations and direct medical costs during the first 3 years.
  
  
  METHODS
  Patients were stratified according to compliance in the first 2 years using the medication possession ratio, where 80% or higher is compliant and less than 80% is noncompliant. The relationship between compliance rates and direct medical costs was evaluated using a generalized linear model. Adjusting for covariates that may affect cardiovascular risk, the relationship between compliance and the likelihood of hospitalization was assessed using logistic regression models.
  
  
  RESULTS
  The 2-year medication possession ratio was 80% or higher in 3512 patients (compliant) and was less than 80% in 6715 patients (noncompliant). Compared with the noncompliant patients, the compliant patients during year 3 had significantly fewer hospitalizations (16% vs 19%) and lower total direct medical costs (excluding the cost of statin therapy) ($4040 vs $4908 per patient) (P <.01 for both).
  
  
  CONCLUSIONS
  Compliance with statin therapy in the first 2 years of use may reduce hospitalization rates and direct medical costs in the subsequent year.
authors.affiliation: Medco Health Solutions, Inc, Franklin Lakes, NJ 07417, USA. ronald_aubert@medco.com
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Aubert
authors.forename: Jianying
authors.initials: J
authors.lastname: Yao
authors.forename: Fang
authors.initials: F
authors.lastname: Xia
authors.forename: Susan B
authors.initials: SB
authors.lastname: Garavaglia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000517:prevention & control; D004180:Direct Service Costs / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006302:Health Services Research; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007344:Insurance Claim Reporting / Q000706:statistics & numerical data; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D040242:Risk Reduction Behavior; D016903:Drug Monitoring
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors