The Pharmaceutical Benefits Scheme (PBS) medication usage data is now available for the 2016-2017 financial year. Statins consistently feature in the lists of most dispensed medications, and this year is no different. Atorvastatin and rosuvastatin occupy the top two spots by prescription count with a combined total of 20,593,813 prescriptions.

Although statins are primarily prescribed to lower serum cholesterol levels, research suggests that their benefits extend much further. A study recently presented at the EuroCMR conference proposes that statins can improve the function of blood vessels, reduce inflammation, and stabilise fatty plaques in blood vessels. The lead author also went on to describe the potential benefit of reducing left ventricular hypertrophy, possibly due to reduced oxidative stress and growth factor production. This research adds to evidence from randomised controlled trials demonstrating that after 12 months of therapy, statins reduce the risk of major cardiovascular events by around 25% for each mmol/L reduction in low density lipoprotein (LDL).

The benefits reported in these studies outweigh the known adverse effects of statin therapy. While the consequences of major cardiovascular events can be devastating and lifelong, most adverse effects associated with statins usually resolve completely upon treatment cessation. Common adverse effects include mild and transient gastrointestinal symptoms, headache, and sleep disturbances. Myopathy and the more serious rhabdomyolysis are rare and dose-related.

Statins are currently subsidised on the PBS for very high-risk patients at any cholesterol level, or according to lipid levels described in the General Statement for Lipid-Lowering Drugs Prescribed as Pharmaceutical Benefits.

References:

  1. Collins R, Reith C, Emberson J, Armitage J, Baigent C, Blackwell L, et al. Interpretation of the evidence for the efficacy and safety of statin therapy. Lancet. 2016; 388(10059); 2532-61.
  2. European Society of Cardiology. Statins associated with improved heart structure and function. Sophia Antipolis: ESC; 2017.
  3. National Prescribing Service. Top 10 Drugs 2016-17. Aust Prescr. 2017; doi 10.18773.

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