Statin prescribing in Australia: socioeconomic and sex differences. A cross-sectional study

Med J Aust. 2004 Mar 1;180(5):229-31.

Abstract

Objective: To assess if there are any differences in statin prescribing across Australia by socioeconomic status or sex and to relate prescribing rates to coronary heart disease (CHD) mortality rates.

Design: Cross-sectional study using data on statin prescribing by age, sex and patient postcode for the period May to December 2002.

Setting and participants: The Australian population, stratified by sex and quintile of Index of Relative Socio-Economic Disadvantage (IRSD).

Main outcome measures: Age-standardised rates of statin scripts per 1000 population per month for each sex and IRSD quintile.

Results: 9.1 million prescriptions for statins were supplied between May and December 2002, for a total cost of 570 million dollars. The age-standardised rates for statin prescribing in women varied from 56.9 (95% CI, 56.6-57.2) scripts per 1000 population per month in the most disadvantaged socioeconomic quintile through 53.4 (95% CI, 53.0-53.7), 50.3 (95% CI, 50.0-50.6), 48.4 (95% CI, 48.1-48.7) to 46.3 (95% CI, 46.0-46.6) in the least disadvantaged quintile. For men the figures were 52.6 (95% CI, 52.3-52.9), 50.9 (95% CI, 50.6-51.2), 48.8 (95% CI, 48.6-49.1), 47.7 (95% CI, 47.4-47.9), and 51.9 (95% CI, 51.6-52.2). There was a significant linear association between statin prescribing and CHD mortality by quintile of socioeconomic disadvantage in women (weighted least squares slope, 0.380; 95% CI, 0.366 to 0.395; P < 0.0001), but not in men (slope, -0.002; 95% CI, -0.010 to 0.006; P = 0.65).

Conclusions: Our results suggest that in men there is either overprescribing of statins in the highest socioeconomic quintile or underprescribing in the lowest. Furthermore, contrary to expectation, women - relative to men - are prescribed statins at higher rates at lower levels of risk (using CHD deaths as a proxy measure of risk).

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Australia / epidemiology
  • Coronary Disease / mortality
  • Coronary Disease / prevention & control*
  • Cross-Sectional Studies
  • Drug Utilization / statistics & numerical data*
  • Family Practice*
  • Female
  • Health Care Surveys
  • Health Services Accessibility*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Least-Squares Analysis
  • Linear Models
  • Male
  • Middle Aged
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Sex Distribution
  • Sex Factors
  • Socioeconomic Factors
  • Vulnerable Populations

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors