Background: Lipid-lowering drug (LLD) treatment is important for cardiovascular risk reduction in type 2 diabetes. Statins are first choice of treatment but increasing public concern of side effects may have changed the prescription patterns of LLDs. We mapped trends in LLD usage among type 2 diabetes patients in Denmark from 1997 to 2017.
Methods: The study population was defined as all persons registered with type 2 diabetes in the national registers in the period 1997 through 2017. All redeemed LLDs (ATC-codes: C10) were extracted from the Register of Medicinal Product Statistics. Medication coverage at any given day was calculated based on amount purchased and doses prescribed if recorded; otherwise on Defined Daily Dose.
Results: A total of 420,751 persons living in Denmark with type 2 diabetes was included. Out of these, 266,385 (63%) individuals redeemed at least two LLD prescriptions in the period. The proportion covered by LLDs increased from 24% in 1997 to 58% in 2013, where after it declined (Figure 1). By 2017, 35% of the population was on simvastatin, 15% on atorvastatin, 4% on rosuvastatin, 2% on ezetemibe and 1% on other drugs.
Conclusion: Changing guidelines has had a clear impact on the actual use of LLDs among type 2 diabetes patients, but the declining tendency emphasize that there is still room for improvement. There was, however, not a noteworthy shift from statins to other drugs.
P.F. Rønn: Research Support; Self; Amgen AB. Stock/Shareholder; Spouse/Partner; Novo Nordisk A/S. B. Carstensen: Consultant; Self; Leo Pharma. Speaker's Bureau; Self; Novo Nordisk A/S. Stock/Shareholder; Self; Novo Nordisk Inc. J.S. Knudsen: None. F. Persson: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Novo Nordisk A/S. Research Support; Self; AstraZeneca, Sanofi. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim International GmbH, Merck Sharp & Dohme Corp., Novo Nordisk A/S, Sanofi. M.E. Jørgensen: Research Support; Self; Amgen Inc., AstraZeneca, Danish Diabetes Association, Sanofi-Aventis. Stock/Shareholder; Self; Novo Nordisk A/S.