An earlier internal analysis on cardiovascular disease measures (completed in partnership with the RAND Corporation) found a significant gender disparity in compliance for LDL screening and control in both the diabetic and the CAD population. This research was also supported by evidence in literature that women are less likely to adhere on therapy than men. The objective of this study was to measure the gender disparity in the initiation and adherence of Statin therapy in the CAD population and identifying the factors associated with the disparity.
We examined pharmacy and medical claims for Cigna's commercial population aged 18 years and older with a diagnosis of coronary artery disease in 2016. We studied prescription use, access to quality of care and co-morbidities in addition to the demographic variables as potential predictors of the gender disparity in Statin initiation and adherence.
We found that women were significantly less likely to initiate Statins following a CAD episode than men (71.1% vs 81.7%, p<0.05). Not only were women less likely to initiate Statin therapy, women also were less likely to stay adherent to the therapy than men, average PDC was 83% in women versus 86% in men. Age, race and comorbidity conditions such as Depression, Hypothyroidism and inflammatory conditions were also found to be potential predictors in Statin therapy adherence.
Although we did not establish a causal relationship, we did find potential opportunities to improve cardiovascular outcomes and statin utilization in women. This study can be used as a starting point to facilitate interventions to reduce the gender disparity in CAD patients.
© 2020 Published by Elsevier Inc.