Economic Aspects of Adherence to Hyperlipidemia Treatment in Sweden

Abstract: Cardiovascular disease is the leading cause of premature death world-wide and contributes extensively to the escalating costs of healthcare. Given the importance and effectiveness of lipid-lowering therapies for treatment of cardiovascular disease, understanding and quantifying impacts of poor treatment adherence is crucial. The objective of the present study was to estimate persistence and compliance to treatment of hyperlipidemia in Sweden and relate poor treatment adherence to healthcare resource utilization and subsequent costs. The study design was a retrospective register study based on a matched control cohort design using patient-level data from three national registers. The study found that 29 percent of treatment-naïve patients in Sweden were no longer persistent to lipid-lowering therapies one year after initiating treatment and more than half of the patients, 53 percent, were non-persistent after three years. It was more common amongst non-compliant patients to suffer cardiovascular event during the follow-up period of three years. The non-compliant patients were also found to have 8 - 47 percent higher healthcare costs during the second and third year after initiating treatment compared to their compliant counterparts. The results indicate potential for interventions aimed at improving adherence and highlights the need to properly analyze the net cost effect of such interventions.