Effectiveness of statins in Medicare‐eligible patients and patients < 65 years using clinical practice data *

Summary Objective:  This study compared effectiveness of rosuvastatin (RSV) with other statins on lowering LDL‐C and LDL‐C goal attainment among Medicare‐eligible patients (age ≥ 65 years) and patients with age < 65 years treated in usual clinical practice to provide evidence of real‐world effectiveness of statins. Methods:  Retrospective cohort study was conducted in patients, newly prescribed statin therapy during August 2003 to May 2005. Patient inclusion criteria: no prior prescription for dyslipidaemic medication in the preceding 12 months, continuously enrolled for ≥ 15 months and ≥ 90‐day supply of statin. Effectiveness of RSV in reducing LDL‐C and attaining LDL‐C goal when compared with other statins was evaluated using multivariate regression, adjusting for baseline LDL‐C, age, gender, smoking, hypertension, coronary heart disease (CHD), systolic blood pressure and therapy duration. Results:  Adjusted per cent LDL‐C reduction was significantly greater (p < 0.05) with RSV (24.3% for ≥ 65 and 28.5% for < 65) compared with ATV (17.5%, 21.3%), SMV (14.8%, 18.4%), PRV (11.3%, 15.8%), FLV (10.7%, 20.6%) and LOV (13.3%, 14.4%). Among patients in both age groups at high or moderate CHD risk, a greater proportion of RSV patients attained LDL‐C goal (76.0% for age group ≥ 65 years and 78.4% for age group < 65 years) vs. 50.5–73.0% for ≥ 65 and 51.3–71.5% for < 65 years of age on other statins (p < 0.0001). Conclusions:  Rosuvastatin is more effective in lowering LDL‐C in Medicare‐eligible patients and patients < 65 years of age when compared with other statins in usual clinical practice. Moreover, RSV patients had higher LDL‐C goal attainment rates when compared with other statins in high‐ and moderate‐risk patients. The study results have implications for clinicians in selecting the optimal statin to meet individual patient care needs.