Author + information
- Pallavi Ranea,b,
- Jeetvan Patela,b,
- David Harrisona,b,
- Hollie Baileya,b,
- Andrea Leitha,b,
- James Piercya,b and
- Jason Shepherda,b
Background: The 2013 ACC/AHA guidelines recommend high intensity statins for all high risk patients to reduce the risk of subsequent cardiovascular events. Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) were introduced in 2015 as adjunctive therapy for patients needing additional lowering of low-density lipoprotein cholesterol (LDL-C) despite being on maximally tolerated statin dose. The new ACC/AHA expert consensus decision pathway on non-statin therapies for LDL-C lowering recommends statins as first line therapy followed by ezetimibe prior to a trial of a PCSK9i. The goal of this study was to assess cardiologists’ and primary care physicians’ (PCPs) perspectives and current treatment choices for patients with dyslipidemia.
Methods: Data were obtained from the 2016 Adelphi Dyslipidemia Disease Specific Programme (DSP), a cross-sectional survey of a geographically representative sample of physicians in the United States. Physicians provided information about their current prescribing patterns and perspectives related to lipid lowering therapies (LLTs) in patients with dyslipidemia.
Results: This DSP surveyed 53 cardiologists and 76 PCPs. A greater proportion of cardiologists (68%) reported prescribing PCSK9i vs PCPs (26%), and a greater proportion of PCPs reported prescribing statins and ezetimibe only (63%) vs cardiologists (25%). A small proportion of both cardiologists and PCPs reported prescribing statins only (8% and 11%, respectively). Cardiologists reported that 37% of their patients were currently not well controlled on their LLTs vs PCPs who reported that 34% were uncontrolled. Differences were also observed between cardiologists and PCPs in the factors influencing their selection of treatments. Only 24% of cardiologists reported that their treatment choices were driven by insurance coverage, vs 41% of PCPs. Fewer cardiologists (38%) reported basing treatment decisions on a specific LDL-C target vs 45% of PCPs.
Conclusions: The study results indicate that cardiologists have more rapidly adopted PCSK9i than PCPs, and that their prescribing choices are less influenced by health plan formularies.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in Lipid Management
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1203-312
- 2017 American College of Cardiology Foundation