Study of drug utilization, morbidity pattern and cost of hypolipidemic agents in a tertiary care hospital

Kamlesh P. Patel, Harsh M. Joshi, Chintan Khandhedia, Harsh Shah, Kartik N. Shah, Varsha J. Patel


Background: Data on the extent of use and costs of lipid-lowering agents are not widely available. Our aim was to study the drug utilization and morbidity pattern, cost of different hypolipidemic drugs along with the risk assessment for coronary heart disease.

Methods: After approval of protocol by the Institutional Review Board, an observational, prospective study was carried out in 300 patients using NCEP and ATP III Guidelines-2002 for evaluation of presence or absence of risk factors for coronary heart diseases. Data were analysed using SPSS software version 16.0and WHO Core Drug Prescribing Indicators.

Results: Patient’s morbidity pattern revealed that 62%, 49.3%, 28% suffered from ischemic heart disease, hypertension and type 2 diabetes mellitus respectively. On risk assessment, 48%, 13.3% patients had borderline and high level of total cholesterol respectively; 42%, 22.7% had borderline and high triglyceride levels respectively; 71.1% men and 62% women had low HDL cholesterol levels while 17.3%, 6% and 2.7% patients had borderline high, high and very high level of LDL cholesterol levels respectively. Frequency of prescriptions was atorvastatin (82%), rosuvastatin (9.3%) and simvastatin (4.7%) among the most frequently prescribed statins drug group. The mean number of drugs per prescription was 7.34. Drugs prescribed by generic name and from essential drugs list was 24.96% and 71.81% respectively. Mean cost of hypolipidemic agents/prescription/day was 10.74 (±1.96) Indian Rupees with rosuvastatin being the costliest.

Conclusion: Rational use of hypolipidemic agents with an increasing trend of statins prescriptions will significantly reduce the morbidity and mortality from coronary heart diseases. 


Coronary heart disease, Dyslipidemia, Hypolipidemic agents, Statins

Full Text:



Prabhakaran D, Yusuf S, Mehta S, Pogue J, Avezum A, Budaj A, et al. Two-year outcomes in patients admitted with non-ST elevation acute coronary syndrome: results of the OASIS registry 1 and 2. Indian Heart J 2005;57(3):217-25.

Siegel D, Lopez J, Meier J. Use of cholesterol-lowering medications in the United States from 1991 to 1997. American Journal of Medicine 2000;108:496-9.

Walley T, Folino-Gallo P, Stephens P, Van Ganse E. Trends in prescribing and utilization of statins and other lipid lowering drugs across Europe 1997-2003. British Journal of Clinical Pharmacology, 2005,60:543-51.

Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Journal of American Medical Association (JAMA) 2001;285:2486-97.

Goyal Pankaj, Geeta Sharma, Baljinderpal S, et al. Prospective, non-interventional, uncontrolled, open-chart, pharmacoepidemiologic study of prescribing patterns for lipid-lowering drugs at a tertiary care teaching hospital in North India. Clinical Therapeutics 2002;24(12):2064-76.

Sleator DJ. Towards accurate prescribing analysis in general practice: accounting for the effects of practice demography. British Journal of Clinical Pharmacology 1993;43:102-6.

Roe C, McNamara A, Motheral B. Gender and age-related prescription drug use patterns. Annals of Pharmacotherapy 2002;36:30-9.

Fareedullah Md, Sreedevi K, Venkateswara Rao J, Vijayakumar S. A study on prescription pattern of statins in cardiovascular disease. Scholars Research Library Der Pharmacia Lettre 2011;3(3):393-6.

Pillai PG, P. Suresh, Gayatri Aggarwal, Gaurav Doshi, Vidhi Bhatia, Harsha Kathpalia. Studies on the prescriptions of cardio vascular units. Journal of Applied Pharmaceutical Science 2011;1(3):128-31.

EURO-MED-STAT, 2006. Available at http://www. Accessed 25 February 2013.

Krishna K Sharma, Rajeev Gupta, Aachu Agrawal, Sanjeeb Roy, Atul Kasliwal, Ajeet Bana, et al. Low use of statins and other coronary secondary prevention therapies in primary and secondary care in India. Vascular Health and Risk Management 2009;5:1007-14.

De Backer G, Ambrosioni E, Borch-Johnsen K, et al European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. European Heart J 2003,24:1601-10.

Sacks FM, Pfeffer MA, Moye LA, Rouleau JL, Rutherford JD, Cole TG, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events Trial investigators. N Engl J Med. 1996 Oct 3;335(14):1001-9.

Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994 Nov 19;344(8934):1383-9.

Gibson CM. NRMI and current treatment patterns for ST-elevation myocardial infarction. Am Heart J. 2004 Nov;148(5 Suppl):S29-33.

Xavier D, Pais P, Devereaux PJ, Xie C, Prabhakaran D, Reddy KS, et al. Treatment and outcomes of acute coronary syndromes in India (CREATE): a prospective analysis of registry data. Lancet. 2008 Apr 26;371(9622):1435-42.

Rathnakar UP, Sheethal D. Ullal, Shruthi Sadanand, et al. Profile of Drug Utilization Among Elderly Patients Attending A Cardiology Clinic In Mangalore, India Journal of Pharmacy Research. 2010;3(8):1835-7.

Victora CG, Facchini LA, Grassi Filho M. Drug usage in southern Brazilian hospitals. Trop Doct. 1982 Oct;12(4 Pt 2):231-5.