Prescribed Daily Doses (PDDs) of Hypolipidaemic Agents in South Africa with Emphasis on HMG CoA Reductase Inhibitors

Dyslipidaemia is a major cardiovascular risk factor in the South African population. The primary aim of the study was to determine the prescribing patterns of hypolipidaemic agents on the South African market with specific emphasis on the Prescribed Daily Doses (PDDs) of HMG CoA reductase inhibitors (statins). A retrospective, cross-sectional pharmacoepidemiological study was conducted on 2011 claims data. All records for hypolipidaemic agents were extracted for analysis. A total of 4 805 patients (56.88% males) were prescribed 38 373 hypolipidaemic agents. The average age of patients was 56.07 (SD=13.32) years. Statins accounted for 93.85% of all prescriptions, followed by fibrates (3.61%). Simvastatin was the most frequently prescribed statin (accounting for 62.59% of all prescriptions), followed by atorvastatin (17.04%) and rosuvastatin (11.68%). The average PDDs were generally lower or in agreement with the Defined Daily Doses (DDDs), except for rosuvastatin. The average PDD of simvastatin was 23.70 mg (DDD=30 mg), pravastatin 25.35 mg (DDD=30 mg), lovastatin 26.31 mg (DDD=45 mg), atorvastatin 20.91 (DDD=20 mg) and fluvastatin 57.29 mg (DDD=60 mg). The average PDD of rosuvastatin was 15.02 mg and the DDD only 10 mg. The fibrates constituted 3.61% of prescribing. Only one cholesterol absorption inhibitor drug was prescribed (ezetimibe). Other hypolipidaemic agents prescribed accounted for only 0.89%. A variety of generic equivalents were available for the statins. Further studies are needed to investigate clinical parameters and diagnoses in relation to the PDDs.