Assessing the results: Phase 1 hyperlipidemia outcomes in 27 health plans

In phase 1 of this hyperlipidemia outcomes management program, characteristics of 7,619 patients treated with statins at 27 US managed care plans were determined. Nearly 40% (3,018 patients) had documented coronary heart disease (CHD). Most (65%) had at least two CHD risk factors. Hyperlipidemia treatment included simvastatin (39%), atorvastatin (25%), fluvastatin (14%), pravastatin (12%), and lovastatin (2%). On-treatment low-density lipoprotein cholesterol (LDL-C) levels were available for 79% of patients; however, only 46% had both baseline and follow-up levels recorded in their charts. Of patients for whom follow-up data were available, 3,779 (63%) achieved their target LDL-C levels as recommended by the National Cholesterol Education Program (NCEP). Target LDL-C levels were reached by 1,381 (87%) of the patients with a goal of 160 mg/dL, 1,326 (65%) of those with a goal of 130 mg/dL, and 1,072 (44%) of those with a goal of 100 mg/dL. Overall, 66% of patients who met their treatment goal and 24% of those who did not required no more than a 25% reduction in LDL-C. In contrast, 8% of patients who achieved goals and 36% of patients who did not required >40% reduction in LDL-C. Phase 1 results did not suggest any substantial difference among statins for achievement of NCEP goals or decrease in LDL-C. These results show that therapy with statins is effective for achievement of NCEP targets in most patients and that there is potential for improvement in the quality and cost-effectiveness of statin therapy with carefully planned interventions.