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Efficacy of atorvastatin when not administered daily
Antonio Edmond Ghattas1, João Pimenta
1Hospital do Servidor Público Estadual, São Paulo, SP, Brasil. tghattas@cardiol.br
Insights
Non-daily statin use, specifically atorvastatin, effectively lowers LDL-cholesterol and reduces costs. This dosing strategy offers a viable alternative for managing hypercholesterolemia while achieving significant savings.
Area of Science:
- Cardiovascular Medicine
- Pharmacoeconomics
- Clinical Pharmacy
Background:
- Statins are crucial for reducing cardiac events but are often prescribed daily.
- Non-daily statin regimens are sometimes used to decrease patient costs.
Purpose of the Study:
- To assess the efficacy of non-daily atorvastatin in managing LDL-cholesterol (LDL-C).
- To evaluate the potential cost reductions associated with a non-daily dosing schedule.
Main Methods:
- 100 hypercholesterolemia patients (primary/secondary prevention) received atorvastatin 10 mg daily after a diet period.
- Dosage was reduced weekly (5 or 3 times/week) if LDL-C targets were met (<80 mg/dL for SP, <104 mg/dL for PP).
- Cost variations were analyzed to determine savings.
Main Results:
- Patients on reduced atorvastatin schedules (5 or 3 times/week) achieved significant LDL-C reductions (46.1% and 42.4%, respectively).
- Monthly medication costs decreased by 30% to 50% in the non-daily dosing groups.
- The study demonstrated sustained LDL-C control with intermittent dosing.
Conclusions:
- Atorvastatin can be effectively administered on a non-daily basis.
- Non-daily dosing significantly reduces medication costs without compromising LDL-C control.
- This approach presents a cost-effective strategy for hypercholesterolemia management.
Background:
Statins are widely used because they reduce cardiac events. Although they are indicated for daily use, some doctorsgive prescriptions for every other day, mainly with the purpose of reducing costs.
Objective:
To evaluate the efficacy of atorvastatin, when not administered everyday, on LDL-cholesterol (LDL-C) levels, and also to evaluate cost reduction.
Methods:
A total of 100 patients with hypercholesterolemia in primary (PP) and secondary prevention (SP) were assessed. After a 12-week diet period, atorvastatin was initiated at a dose of 10 mg per day. After six weeks, LDL-C was determined, and if the levels were <80 or <104 mg/dL for SP and PP, respectively, two atorvastatin doses were subtracted per week. If LDL-C remained <80 or <104 mg/dL, a further reduction to three times a week was allowed, and the last determination was performed after six more weeks. The percentage variation in costs was the parameter to evaluate the saving.
Results:
In 47 out of the 52 patients of this group, a reduction by 32% in LDL-C was observed, and daily atorvastatin was maintained. Forty one patients remained throughout the study and had their weekly dosage reduced. In 25 patients the medication was administered three times a week, and in 16, five times a week, with reductions of 42.4% and 46.1% in LDL-C, respectively. As regards costs, one of the groups had their monthly expense reduced from R$ 106.65 to R$ 74.65, and the other group from R$ 106.65 to R$ 53.33.
Conclusion:
The results suggest that atorvastatin may be administered on a non-daily basis. A cost reduction between 30% and 50% was also observed.
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