title: The effect of removing funding restrictions for atorvastatin differed across sociodemographic groups among New Zealanders hospitalised with cardiovascular disease: a national data linkage study.
abstract: OBJECTIVE
  Publicly-funded atorvastatin required prior approval until September 2010 whereas simvastatin did not. Our aim was to examine if overall statin dispensing and atorvastatin dispensing among patients hospitalised for cardiovascular disease (CVD) differed systematically across sociodemographic groups during and after special authority criteria.
  
  
  METHODS
  National medication dispensing data were anonymously linked to patients hospitalised across New Zealand with CVD and discharged between 1/07/2009-31/12/2009 when special authority criteria applied and 1/09/2010-28/02/2011 after restrictions ceased. Statin dispensing at least once within six months post-discharge was analysed by sociodemographic characteristics.
  
  
  RESULTS
  Overall statin use was the same (80%) among patients discharged during (n=14,094) and after (n=13,274) restrictions. With restrictions, atorvastatin dispensing was 32-33% less frequent among statin-users <45 years and >75 years than 65-74 year olds and 28-55% less among Māori, Pacific and Indian peoples than all others. Minimal relative differences occurred by sex or deprivation status. After restrictions were lifted, the proportion of statin-users dispensed atorvastatin increased around two-fold or more across all sociodemographic strata with three-four fold increases for patients >55 years and for Māori, Pacific and Indian peoples.
  
  
  CONCLUSIONS
  After funding restrictions ceased, disparities in atorvastatin dispensing appeared to reduce across age and ethnic groups among patients with CVD-related hospitalisations, but overall statin use was unchanged.
authors.affiliation: Research Fellow, Section of Epidemiology and Biostatistics, University of Auckland, Auckland.
authors.forename: Suneela
authors.initials: S
authors.lastname: Mehta
authors.affiliation: Associate Professor, Section of Epidemiology and Biostatistics, University of Auckland, Auckland.
authors.forename: Sue
authors.initials: S
authors.lastname: Wells
authors.affiliation: Professor of Epidemiology, Section of Epidemiology and Biostatistics, University of Auckland, Auckland.
authors.forename: Rod
authors.initials: R
authors.lastname: Jackson
authors.affiliation: Senior Lecturer, School of Pharmacy, University of Auckland, Auckland.
authors.forename: Jeff
authors.initials: J
authors.lastname: Harrison
authors.affiliation: Clinical Head, Department of Cardiology, Middlemore Hospital, Auckland.
authors.forename: Andrew
authors.initials: A
authors.lastname: Kerr
mesh_terms: D000328:Adult; D000368:Aged; D000069059:Atorvastatin / Q000191:economics* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000401:mortality*; D011307:Drug Prescriptions / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D016247:Information Storage and Retrieval; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012044:Regression Analysis
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069059:Atorvastatin