New patient starts in three of the largest US retail prescription categories – cholesterol reduction, diabetes and hypertension – will be relatively flat in 2009, showing growth of less than 5% each, according to health care analytics firm SDI.

The indication that many patients are going without health care coverage, and sometimes their medications, “does not bode well for how many new patients will begin prescription therapy in 2009,” says SDI chief operating officer John Ross. However, while demand for medications in these three therapy areas is expected to level off in 2009, it should improve from there, he adds.

The cholesterol reducer market will be of particular interest next year, in light of the November JUPITER study findings which provided evidence that AstraZeneca’s Crestor (rosuvastatin) reduces heart attacks, strokes, and deaths due to cardiovascular disease in people with no signs of heart disease, says SDI. Crestor's overall US market share has increased 1 percentage point since January 2008 and, overall, the number of monthly US retail prescriptions for cholesterol-reducers nearly doubled from 9.8 million in January 2002 to 18.8 million in October 2008, says the firm, which is forecasting 3% growth in new patient therapy starts in the US for these products next year.

Turning to the diabetes market, the study notes that there are new products in the pipeline from various manufacturers, but a key question will be whether or not recent safety concerns will result in increased regulations, possibly impacting short-term performance and long-term R&D investments. The US diabetes therapy market grew 44% from 8.9 million monthly retail prescriptions in January 2002 to 12.8 million in October 2008, and SDI is projecting just 2% growth in new patient therapy starts in this market next year.

The report also points to the findings from the Kaiser Family Foundation’s most recent Health Tracking Poll in October, which revealed that 47% of the public reported that they or a family member had, because of cost issues, failed to fill a doctor’s prescription, skipped a recommended medical test or treatment, cut pills or skipped doses of medicine or had had problems getting mental health care, compared with 42% in April.

And last week, another study found that nearly 40 million US adults failed to fill a prescription in the past year because of cost. The survey, by Manhattan Research, reported that women and patients with neurological and mental health conditions were the most likely to give up their medication because of cost problems.