Drug Utilisation patterns, cost effectiveness and patient compliance of statins among patients of diabetes mellitus at a tertiary care hospital

OBJECTIVE: The objective of this study was to determine the drug utilization patterns and cost-effectiveness of statin therapy in diabetic patients as well as their compliance towards the prescribed statin.

DESIGN: Prospective observational cross-sectional study

SETTING: 700 bedded tertiary care hospital.

PARTICIPANTS: A total of 120 diabetic patients, involving both sexes and all ages, admitted to endocrinology ward or attending one of the endocrinology OPD clinics for a period of 4 months were included in the study

RESULTS: Out of 120, a total of 57 patients had a statin being prescribed in their prescription. Statin prescription was restricted to Atorvastatin and Rosuvastatin only with Atorvastatin being prescribed in 50.87% patients and Rosuvastatin in 49.11% patients. The average per month expenditure of statins varied considerably among the different brands of statins being prescribed. There was 1061% variation between the monthly expenditure of lowest cost generic available and highest cost branded form of Atorvastatin 10 mg; in case of Atorvastatin 20 mg the percentage variation in the monthly expenditure of lowest cost generic and highest cost branded form was 841.3%. Out of 57 patients, a total of 40.35% patients were highly adherent to their prescribed statin, while as 47.36% patients had medium adherence and 12.28%  patients were poorly adherent to prescribed statin. 23.52% patients gave non-affordability as the reason for decreased adherence to statins, similarly in 43.75% patients, lack of proper education was the reason of non-adherence, 20.58% patients had polypharmacy and 14.70% patients gave myopathy as the reason for non-adherence to statins.

CONCLUSION: Statin use matches the established standards of care. Statins belong to one of the expensive class of drugs meant for chronic use and one of the reasons responsible for patient non-compliance to statins is their price in a higher range, therefore there is a considerable need for extensive generic prescribing or prescribing low cost brands keeping the fact in mind that more than 60% of people in India do not have access to medicines. Patient counseling and education is an important area which needs considerable attention since it has a direct impact on patients’compliance to prescribed drugs.