Treatment patterns and patient characteristics among early initiators of PCSK9 inhibitors

Figures & data

Figure 1 Study design.

Abbreviations: LLT, lipid-lowering therapy; PCSK9i, proprotein convertase subtilisin/kexin type nine inhibitor.

Table 1 Characteristics of early initiators of PCSK9i therapy by payer type

Baseline characteristics	Total (N=13,151)	Commercial insurance (N=6,730)	Medicare insurance (N=6,421)
Age group (years), %
18–34	0.9	1.3	0.5
35–44	2.6	3.9	1.2
45–54	10.5	16.3	4.3
55–64	25.4	38.6	11.5
≥65	60.7	39.9	82.5
Age
Mean (SD)	66 (10.6)	62.1 (10.6)	70 (8.9)
Median	67	62	71
Gender, %
Male	51.2	56.9	45.4
Female	48.8	43.2	54.7
Geographic region, %
Northeast	18.3	16.3	20.3
Midwest	26.0	18.8	33.6
South	45.5	55.2	35.2
West	10.1	9.6	10.5
Unknown	0.2%	0.1%	0.3%
Preindex medication use, %
Antidiabetic drugs	25.7	22.9	28.5
Antihypertensive drugs	72.4	69.1	75.9
Anticoagulants	36.7	33.7	39.8
Antiarrhythmic drugs	1.1	0.9	1.3
Index therapy prescriber specialty, %
Cardiology	57.4	57.1	57.8
Primary carea	32.0	33.6	30.4
Other/unknown	10.6	9.4	11.9

Note:

a Includes internal medicine and family practice physicians.

Abbreviation: PCSK9i, proprotein convertase subtilisin/kexin type nine inhibitor.

Figure 2 Baseline lipid-lowering therapy utilization among early initiators of PCSK9i therapy.

Abbreviation: PCSK9i, proprotein convertase subtilisin/kexin type nine inhibitor.

Table 2 Baseline lipid-lowering therapy use among early initiators of PCSK9i therapy by payer type

Baseline lipid-lowering therapy	Total (N=13,151)	Commercial insurance (N=6,730)	Medicare insurance (N=6,421)
Preindex statin and/or ezetimibe use 6 months preindex, %
Any lipid-lowering therapy	45.2	47.7	42.6
Statin therapy only	26.1	25.9	26.2
Low-intensity statin	3.3	3.2	3.4
Medium-intensity statin	11.8	11.3	12.4
High-intensity statin	10.9	11.4	10.5
Ezetimibe only	10.1	10.8	9.5
Statin and/or ezetimibe combination	9.0	11.0	7.0
Low-intensity statin	0.7	0.8	0.7
Medium-intensity statin	2.8	3.2	2.4
High-intensity statin	5.5	7.0	3.4
Preindex statin and/or ezetimibe use 12 months preindex, %
Any lipid-lowering therapy	56.5	58.6	54.3
Statin therapy only	34.1	33.6	34.7
Low-intensity statin	13.6	13.7	13.6
Medium-intensity statin	47.7	45.9	49.5
High-intensity statin	38.7	40.4	37.0
Ezetimibe only	12.4	13.0	11.8
Statin and/or ezetimibe combination	10.0	12.0	7.9
Low-intensity statin	8.5	7.7	9.9
Medium-intensity statin	32.5	30.4	35.8
High-intensity statin	59.0	62.0	54.3
Preindex statin and/or ezetimibe use 18 months preindex, %
Any lipid-lowering therapy	62.8	64.7	60.8
Statin therapy only	38.7	38.1	39.4
Low-intensity statin	5.5	5.5	5.6
Medium-intensity statin	18.9	17.9	19.9
High-intensity statin	14.3	14.7	14.0
Ezetimibe only	13.6	14.0	13.1
Statin and/or ezetimibe combination	10.4	12.5	8.3
Low-intensity statin	0.9	1.0	0.9
Medium-intensity statin	3.5	3.9	3.0
High-intensity statin	6.1	7.6	4.4
Preindex statin and/or ezetimibe use 24 months preindex, %
Any lipid-lowering therapy	67.4	69.20	65.5
Statin therapy only	42.3	41.50	43.2
Low-intensity statin	6.2	6.20	6.3
Medium-intensity statin	21.0	19.90	22.1
High-intensity statin	15.1	15.30	14.8
Ezetimibe only	14.4	14.90	13.8
Statin and/or ezetimibe combination	10.7	12.80	8.6
Low-intensity statin	0.9	1.00	0.9
Medium-intensity statin	3.6	4.10	3.2
High-intensity statin	6.2	7.80	4.5

Abbreviation: PCSK9i, proprotein convertase subtilisin/kexin type nine inhibitor.

Figure 3 Time to discontinuation of index PCSK9i among early initiators of PCSK9i therapy, by payer type.

Abbreviation: PCSK9i, proprotein convertase subtilisin/kexin type nine inhibitor.

Table S1 Statin intensity classification

Statin therapy	Daily dose
	Low intensity (mg/day)	Moderate intensity (mg/day)	High intensity (mg/day)	Notes (classification of atypical doses)
Atorvastatin	<10	10 to <40	≥40	30 mg/day = moderate intensity
Fluvastatin	<80	80	n/a	10 mg/day = low intensity
Lovastatin	<40	≥40	n/a	10 mg/day = low intensity 80 mg/day = moderate intensity
Pitavastatin	<2	≥2	n/a
Pravastatin	<40	≥40	n/a	<10 mg/day = low intensity
Rosuvastatin	<5	5 to <20	≥20	<5 mg/day = low intensity 15 mg/day = moderate intensity
Simvastatin	<20	20 to <80	≥80	<20 mg/day = low intensity >40 to <80 mg/day = moderate intensity ≥80 mg/day = high intensity