Trends in the use of lipid-lowering drugs by outpatients with diabetes in Taiwan, 1997-2003.

Purpose: To analyze recent trends in LLD use by outpatients with diabetes in Taiwan over a 7-year period and to see whether the trends are consistent with clinical trial outcomes and published guidelines.

Methods: A cross-sectional survey was implemented using the National Health Insurance Research Database between January 1997 and December 2003. Adult outpatients who had diagnoses of diabetes and dyslipidemia and who had concurrent antidiabetic drug and LLD claim were identified. The prescribing trends were described in terms of the prescribing rates and patterns of LLDs in each study year.

Results: Between 1997 and 2000, fibrates were the most widely prescribed major class of LLDs, while the rates showed a significant decline over time. The proportions of statin use increased 3.3-fold from 20.8% of all LLDs in 1997 to 69.0% in 2003. With the continuous increase in the use of statins, by 2001, they replaced fibrates as the most heavily used LLDs. Monotherapy was the most prominent prescribing pattern comprising 98.1% and 98.3% of all LLD prescriptions in 1997 and 2003, respectively. Among patients with diabetic dyslipidemia plus CHD, the use of statins increased almost threefold instead of a large reduction in the percentage with non-statin class.

Conclusions: The prescribing rates of LLDs shifted from the fibrates to statins, especially in newer statin. The majority of patients were maintained on monotherapy. These findings may imply that management of hyperlipidemia in patients with diabetes had a positive trend towards recent clinical trial outcomes and guideline's recommendation.