Evolution of Hypolipidemic Drug Consumption in France From 2012 to 2022: Impact of European Society of Cardiology Guidelines.

Abstract

<h4>Purpose</h4>The use of hypolipidemic drugs in cardiovascular prevention has evolved in France over the past decade. This study assessed the impact of the 2019 European Society of Cardiology (ESC) guidelines for the management of dyslipidaemias on hypolipidemic drug sales.<h4>Methods</h4>This ecological study reviewed hypolipidemic drug sales in France from January 2012 to December 2022 using the Medic'AM database. For each class of hypolipidemic drugs, the monthly average of defined daily dose per thousand inhabitants per day (DDD/TID) was calculated. Autoregressive models analysed sales trends before and after the ESC guideline publication date. The predictive curve was based on data prior to the ESC guideline publication to calculate the excess of hypolipidemic drug sales between observed and predicted data.<h4>Results</h4>Average monthly sales of hypolipidemic drugs decreased from 110.139 in 2012 to 97.297 DDD/TID in 2018. However, following the publication of the ESC guidelines in August 2019, a significant reversal of this trend was observed, reaching 123.506 DDD/TID in 2022, representing an excess of 788.823 DDD/TID. Yearly associated healthcare expenses decreased from 2012 to 2018, then increased from 699.739 million euros to 830.004 million euros in 2022.<h4>Conclusion</h4>After the 2019 ESC guidelines for the management of dyslipidaemias, an increase in hypolipidemic drug sales in France was found, notably atorvastatin and ezetimibe. Healthcare costs have risen, particularly due to the increased sales of ezetimibe, which is a more expensive third-line treatment. Practice studies are needed to understand the determinants of this massive increase in ezetimibe sales.