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Niacin improves serum lipids, but has not consistently been shown to benefit patient outcomes, particularly in the statin era. The AIM-HIGH trial was stopped early due to lack of niacin efficacy. The HPS-2 THRIVE trial results are eagerly anticipated in March 2013. We sought to determine how niacin was prescribed in the US and Canada prior to these trials and related expenditures.
We conducted a population-level cohort study using IMS Health National Prescription Audit™/IMS Brogan Compuscript® data from 2002-09 to describe prescribing and expenditures of prescription niacin.
696,000 niacin prescriptions were dispensed/month in the US in 12/2009. Per capita niacin prescriptions were ~6-fold higher in the US vs. Canada in 2009. In December 2009, 81.6% and 85.5% of all niacin prescriptions were for Niaspan®, the brand product, in the US and Canada. In 2009, Niaspan® expenditures in US dollars totaled $732,194,000 in the US and $12,377,867 in Canada. Per capita niacin expenditures, adjusted for differences in purchase price parity were nearly 7-fold higher in the US versus Canada.
We found a marked difference in utilization and expenditures of niacin between the US and Canada, with a more conservative initial approach in Canada. Even in Canada, resources are increasingly being directed towards a drug that lacks strong evidence that it improves clinical outcomes in the statin era. Which approach is best may depend on the results that are expected from HPS-2 at this meeting.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Improving Cardiovascular Health Services
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1201-111
- 2013 American College of Cardiology Foundation