A new study has suggested that the use of statin drugs to treat high cholesterol is lower in the USA today than it was in 2000, and that doctors are not prescribing these drugs to patients who need them.

The report, published in the online journal PloS Medicine, found that statins as a class showed phenomenal growth in market share between 1992 and 2002, with their share of prescriptions rising from 47% to 87%, and Pfizer’s Lipitor (atorvastatin) being leading drug in the class. However, between 1992 and 2000, the use of statins increased nearly five-fold, from 9% to 49%, but then fell back to 36% in 2002.

The authors of the study, led by Jun Ma of Stanford University Medical School, conclude that clinical practice is failing to follow recommended treatment guidelines for patients whose elevated cholesterol puts them at moderate-to-high cardiovascular risk, which mandate drug therapy and lifestyle education in all cases. In 2002, statins were prescribed in just 50% of consultations for people at high risk of coronary heart disease and 44% of those at moderate risk, while less than half the visits patients received counselling about how they might change their lifestyle.

Last year, the US National Cholesterol Education Programme unveiled new cholesterol-lowering guidelines that sought to encourage more aggressive use of statins in moderate- to high-risk patients, in what was widely regarded as a significant boost to the multibillion-dollar statin class [[14/07/04b]]. Lipitor itself makes sales in excess of $10 billion dollars a year [[20/04/05a]].