title: Impact of the New ACC/AHA Guidelines on the Treatment of High Blood Cholesterol in a Managed Care Setting.
abstract: BACKGROUND
  In November 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) together issued new guidelines for the treatment of patients with high cholesterol, providing a new paradigm for the management of cholesterol in the primary and secondary prevention of coronary artery disease.
  
  
  OBJECTIVE
  To examine the impact of the 2013 ACC/AHA cholesterol treatment guidelines on pharmacy utilization of cholesterol-lowering drugs in a real-world managed care setting.
  
  
  METHODS
  Pharmacy claims from OptumRx, a national pharmacy benefit management provider, for the period between January 1, 2013, and December 31, 2013 (baseline period), were used to identify candidates for cholesterol-lowering therapy and to estimate the number of potential patients who will be starting or intensifying statin therapy based on the updated cholesterol treatment guidelines. Potential candidates for cholesterol-lowering treatments included patients with diabetes or hypertension aged 40 to 75 years who were not already receiving a cholesterol-lowering medication, as well as patients receiving cholesterol-lowering therapies during the baseline period. The baseline cholesterol-lowering medication market share was used to project changes in pharmacy utilization over the next 3 years.
  
  
  RESULTS
  Based on the 2013 ACC/AHA cholesterol treatment guidelines, there will be a 25% increase in the proportion of the overall population that is treated with statins over the next 3 years, increasing from 3,909,407 (27.7%) patients to 4,892,668 (34.7%) patients. The largest proportion of the increase in statin utilization is projected to be for primary prevention in patients aged 40 to 75 years who were not receiving any cholesterol-lowering treatment at baseline. These projected changes will increase the overall number of statin prescriptions by 25% and will decrease the number of nonstatin cholesterol-lowering medication prescriptions by 68% during the next 3 years.
  
  
  CONCLUSIONS
  The new 2013 ACC/AHA cholesterol treatment guidelines are projected to have a significant impact on the utilization of cholesterol-lowering drugs by increasing the overall proportion of the population receiving statin therapy and by decreasing the utilization of nonstatin cholesterol-lowering medications.
authors.affiliation: Senior Research Consultant, Clinical Programs and Outcomes Research, OptumRx, Irvine, CA.
authors.forename: Josephine N
authors.initials: JN
authors.lastname: Tran
authors.affiliation: Senior Research Consultant, Clinical Programs and Outcomes Research, OptumRx.
authors.forename: Toros
authors.initials: T
authors.lastname: Caglar
authors.affiliation: Senior Director, Clinical Programs and Outcomes Research, OptumRx.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Stockl
authors.affiliation: Vice President, Clinical Programs, OptumRx.
authors.forename: Heidi C
authors.initials: HC
authors.lastname: Lew
authors.affiliation: Chief Medical Officer, Clinical, OptumRx.
authors.forename: Brian K
authors.initials: BK
authors.lastname: Solow
authors.affiliation: Associate Professor, Division of Cardiology, University of Missouri-Kansas City.
authors.forename: Paul S
authors.initials: PS
authors.lastname: Chan