Trends in Ezetimibe Prescriptions as Monotherapy or Fixed-Dose Combination in Germany 2012-2021.

Abstract

Aims:

Addition of ezetimibe to statin therapy is recommended by current guidelines when low-density lipoprotein cholesterol (LDL-C) targets are not achieved with statin monotherapy. Fixed-dose combinations (FDC) improve medication adherence and facilitate risk factor control. We assessed prescription trends of ezetimibe as monotherapy or FDC with statins.

Methods:

Data from the German Institute for Drug Use Evaluation (DAPI) containing dispensing data of >80% of community pharmacies were analyzed. Prescriptions over time of lipid-lowering agents at the expense of the statutory health insurance (SHI) were extrapolated to all SHI-insured persons, representing approximately 88% of the total German population. Drug utilization was expressed as defined daily doses per 1,000 SHI-insured persons per day (DID).

Results:

Of all lipid-lowering drug prescriptions in 2021, 91.2% were statin monotherapy. Ezetimibe was prescribed as monotherapy or FDC with statin in 4.4 and 2.9%, respectively. DID steadily increased for statin (69%) and ezetimibe (424%) monotherapies between 2012 and 2021. In contrast, statin-ezetimibe FDC prescriptions exhibited only a minor increase (29%). The proportion of statin-ezetimibe FDC among all statin prescriptions was stable over time at approximately 3%. FDC prescription rates by specialists were higher compared to general practitioners and varied considerably between geographic areas.

Conclusion:

Combination lipid-lowering therapy is prescribed to a minority of patients. Prescriptions of ezetimibe as monotherapy increased to a much greater extent than statin-ezetimibe FDC. Considering the low proportion of patients achieving their LDL-C target and improved adherence to FDC compared to separate pills, statin-ezetimibe FDC may be utilized to improve the management of dyslipidemia.

• Authors: Julius L Katzmann, Marita Kieble, Salka Enners, Michael Böhm, Felix Mahfoud, Ulrich Laufs, Martin Schulz
• Journal: Frontiers in cardiovascular medicine (Front Cardiovasc Med) Vol. 9 Pg. 912785 ( 2022) ISSN: 2297-055X [Print] Switzerland
• PMID: 35770230 (Publication Type: Journal Article)
• Copyright: Copyright © 2022 Katzmann, Kieble, Enners, Böhm, Mahfoud, Laufs and Schulz.