Table 2.

Summary of Model Inputs and Assumptions

Model inputs

Pharmacy claims from a national PBM provider between November 1, 2012, and October 31, 2013, were used to project the number of potential patients who will be starting or switching statin therapies Potential statin users include: –Continuously eligible patients with diabetes or hypertension aged 40–75 years who are not receiving any cholesterol medications –Continuously eligible patients receiving lower-intensity statins or other nonstatin cholesterol-lowering therapies Baseline cholesterol drugs market share was used to project pharmacy utilization for potential patients who will be starting or switching therapies Expert opinion was used when information was not available in the medical literature

Assumptions

Patients receiving a statin at baseline will not be taken off statin therapy Patients receiving a statin and a nonstatin cholesterol-lowering medication will have the nonstatin agent removed Patients who were not receiving any cholesterol-lowering medications, were aged 40–75 years, and have diabetes or hypertension will start statin therapy; approximately 60% of members receiving hypertension medication and all members receiving diabetes medications will start receiving a statina Approximately 33% of patients receiving nonstatin cholesterol-lowering medications will be switching to statin therapya Approximately 50% of patients receiving low-intensity statin therapies will switch to a moderate-intensity or high-intensity statin therapya Approximately 25% of patients receiving a moderate-intensity statin will switch to a high-intensity statina Patients are assumed to use the same current market share for various statin medications Approximately 66% of patients newly starting statin therapy are projected to continue therapy over timeb

^aEstimates based on expert specialist opinion.

^bEstimate based on ranges between 40% and 73% found in the literature.9–11

PBM indicates pharmacy benefit management.