Please evaluate statin use for MA members with diabetes, cardiovascular disease

The Centers for Medicare & Medicaid Services has increased its emphasis on the appropriate use of statins among Medicare Advantage beneficiaries diagnosed with diabetes and cardiovascular disease. Please evaluate whether your patients with diabetes and/or cardiovascular disease would be appropriate candidates for statin therapy.

 

The 2013 American College of Cardiology and the American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults supports the use of moderate-intensity statin therapy in persons with diabetes 40 to 75 years of age to reduce the risks of atherosclerotic cardiovascular disease (ASCVD) events. High-intensity statin therapy is recommended if the patient has an estimated 10-year ASCVD risk greater than or equal to 7.5 percent. For males 21-75 and females 40-75 years of age with clinical ASCVD, high-intensity statin therapy is recommended unless contraindicated.   These guidelines recommend statin therapy in these scenarios regardless of what patient LDL values are.  Please evaluate if your patients with diabetes and/or cardiovascular disease would be appropriate candidates for statin therapy.

 

Formulary agents are listed below:

Moderate-intensity statin therapy (formulary agents)

 

Drug (brand)	Dose
atorvastatin**	10 mg, 20 mg
rosuvastatin*	5 mg, 10 mg
simvastatin**	20 mg, 30 mg, 40 mg
pravastatin**	40 mg, 80 mg
lovastatin**	40 mg

 

High-intensity statin therapy (formulary agents)

 

Drug (brand)	Dose
atorvastatin**	40 mg, 80 mg
rosuvastatin*	20 mg, 40 mg

 

*Rosuvastatin (Crestor) is a preferred brand medication on the Medicare formulary. 

**Available for a $0 co-pay for most plans in 2018