NZMJ paper shows wide regional variations

NZMJ paper shows wide regional variations in statin use

A new study published in this week’s New Zealand Medical Journal shows wide regional variations in the uptake of the cholesterol-lowering statin drugs.

The paper notes that statins are effective in lowering cholesterol levels and reducing cardiovascular events, such as heart attacks and strokes.

However, the authors point out that uptake rates have been as low as 40 percent of eligible people and that those at highest risk of suffering cardiac events are most likely to be those missing out.

Using data extracted from dispensing claims, the authors calculated that by April 2001 only 67,000 people, or less than 40 percent of those eligible for subsidised treatments, were being prescribed statins.

There were also wide variations in regional dispensing figures. Low figures were recorded in Northland, Ruapehu District, Wairoa and Buller regions, and high figures were recorded in Dunedin, Papakura, Coromandel and New Plymouth.

Highest rates were recorded in: Dunedin City (45.8 percent of people in need)- Central Otago (38.8 percent)- Stratford District (38.7 percent)- Waimakariri District (38.1 percent)- Thames-Coromandel District (34.2 percent) - Papakura (33.2 percent)

Lowest rates were recorded in: Ruapehu District (10.1 percent)- Kaipara (11.4 percent)- Buller (11.7 percent)- Waikato (11.8 percent) - Waitomo District (12.2 percent) - Far North (13.9 percent).

“Such regional differences are difficult to explain,” says PHARMAC medical director Dr Peter Moodie, who co-authored the paper with Wellington public health physician Dr Scott Metcalfe.

“They are not readily explained by the relative ages of populations, nor by rates of cardiovascular disease. However, we are aware that the presence of clinics monitoring cholesterol levels or campaigns targeting this health area are effective in increasing uptake levels. In this respect, clinicians can have a real influence in increasing prescribing levels.”

This year, access to statins has been widened to make them available to up to 300,000 people. In line with this decision, PHARMAC is running a Take Control of Your Cholesterol campaign to raise awareness of cardiovascular risk, and encourage people to make lifestyle changes to lower their risk level and, if necessary, take medicines to lower cholesterol.

“Low uptake rates remain a concern,” Dr Moodie adds. “In particular there are people who have high cardiovascular risk but are difficult to reach. Clinicians have a real role to play here in identifying patients in need and prescribing medicines appropriately.”

“With their help we can ensure that people who can benefit from these cost-effective medicines can get them.”

The full study, including detailed graphs and regional data, is available on the New Zealand Medical Journal website at http://www.nzma.org.nz/journal/index.shtml

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