Abstract

Background: The compliance to statins in secondary prevention is very low, increasing health-care costs principally for rehospitalization. Objectives: To evaluate the cost of lack of persistence to statin therapy together with identification and cost-estimation of poor compliance. Methods: Retrospective observational study starting from administrative database analysis of statin prescription after myocardial infarction. Results: Among 463 patients enrolled, 25.1% were never treated, 70.8% received statins regularly; 14.9% received only 1-2 prescriptions (spot prescription), and 12% were occasional users. Among the 288 nonoccasional users, we found a compliance rate of 80% only in the 59.7%. The cost analysis shows that 59.787,72€ (23.4%) have been spent for patients with compliance of less than 80% (ineffective adherence). Conclusions: As the lower compliance affects the health-care costs, the identification of occasional users and spot prescriptions of the nonoccasional users, has a potential role in reducing medical expense with limited increase in costs.

Key words: cardiovascular prevention; myocardial infarction; statin therapy; cost-effectiveness; healthcare costs.