Trends in Management of Dyslipidaemia in Australia Over the Last 5 Years

Abstract

Objectives: Dyslipidaemia is one of the most prevalent chronic conditions in Australia. While statins have long been the first line treatment for dyslipidaemia, several new medications have been introduced in recent years. We examined the trends in prescription of lipid lowering medications in Australia over the past 5 years. Methods: Data was extracted from the Pharmaceutical Benefits Scheme (PBS). We assessed total number of scripts and costs of statins including Atorvastatin, Fluvastatin, Pravastatin, Rosuvastatin and Simvastatin, as well as Ezetimibe, Fenofibrate, Gemfibrozil, Colestyramine and Evolocumab from December 2013- December 2018. Linear trend modelling was used to analyse trends. Results: Statins continue to be the most commonly prescribed lipid lowering therapy, with Atorvastatin remaining the most popular across all states in Australia (44.1%). Rosuvastatin use increased by 265% from April to December 2018 (40.9%), surpassing Simvastatin (11.6%) as the 2nd most commonly prescribed statin. Of all non-statin drugs, Ezetimibe was the most popular followed closely by fibrates. Since their introduction in December 2016, uptake of Evolocumab has been steady and linear but slow. In December 2018, Evolocumab represented only 0.04% of all scripts but 2.58% of total cost of lipid lowering medications. Queensland had the highest uptake of Evolocumab followed closely by Victoria and New South Wales. Conclusions: Statins continue to be the mainstay treatment for dyslipidaemia in cardiovascular disease with recent increase in use of Rosuvastatin. Despite significant benefits of Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, uptake of Evolocumab appears slow in Australia.