(198) Utilisation Patterns and Trends of Statins in Kuwait from 2012 to 2022: A Population-Based Study

Background: Statins have been commonly used as the cornerstone therapy for dyslipidaemia and cardiovascular diseases management and prevention. While the treatment of elevated low-density lipoprotein cholesterol has changed in recent years after the introduction of PCSK9 inhibitors, it is essential to investigate the patterns and trends of statins.

Objectives: To examine utilisation patterns and trends of statins in Kuwait from 2012 to 2022.

Methods:

Design: A retrospective, repeated cross-sectional study. Setting: The electronic system of the Central Medical Store was used to retrieve annual aggregated data for the utilisation of statins between 2012 and 2022. Subjects: Statins were categorised into high intensity statin therapy (HIST) (atorvastatin 40mg & rosuvastatin 20mg) and moderate intensity statin therapy (MIST) (atorvastatin 10-20mg, rosuvastatin 10mg, and simvastatin 20-40mg). Outcomes: The utilisation of statins was quantified using number of units supplied/1,000 inhabitants/year and defined daily doses (DDDs)/1,000 inhabitants/day (TID), stratified by hospitals and primary healthcare centres (PHCCs). Statistical analysis: Change in trends were presented as absolute and relative changes. Linear trend regression was used to calculate the average annual change in utilisation overtime.

Results: The overall use of statins increased by 41% (n= 54,501) in terms of units supplied/1,000 inhabitants/year and by 102% (n= 53) in terms of DDD/TID, with a significant annual increase of 5,800 and 10 (p < 0.001), respectively. There was a 23% (n= 24,260) decrease of atorvastatin in the number of supplied units/1,000 inhabitants/year. However, atorvastatin was the most commonly utilised agent (42%-80%). For other agents, there was a significant increasing trend in the number of supplied units for both rosuvastatin (1,558% (n= 65,170)) and simvastatin (33% (n= 9,408)). The trends of statins increased in PHCCs; 151% (n= 74,507) in the number of supplied units and 256% (n= 43) in DDD/TID. On the contrary, in hospitals, the trend in terms of the number of supplied units decreased (24% (n= 20,006)) while the trend in terms of DDD/TID increased (26% (n= 9.1)). MISTs were the most utilised intensity over the study period. However, there was an increasing trend in the utilisation of HISTs; 1,946% (n= 47,176) in terms of the supplied units and 1,830% (n= 45) in terms of DDD/TID.

Conclusions: There was an increase in the utilisation trends of statins at national level. In hospitals, the increasing trend in terms of DDD/TID despite a decreasing trend in the number of supplied units could be due to using of HIST for cardiovascular high-risk patients. Despite the high utilisation of MISTs, the trend of HISTs has increased during the study period. To accurately reflect clinical practice, it is imperative to incorporate patient-level data for a more individualised understanding of patient outcomes.