URBAN-RURAL DISPARITIES IN THE PRESCRIPTION OF NOVEL LIPID-LOWERING THERAPIES

作者：Jimin Hwang, Emily Decicco, Eric Peterson, Anand Gupta, Evelyn Sarnes, Ann Marie Návar · 发表于：American Journal of Preventive Cardiology · 年份：2025 · DOI：10.1016/j.ajpc.2025.101090 · 研究领域：Pharmaceutical Practices and Patient Outcomes、Lipoproteins and Cardiovascular Health、Pharmaceutical Economics and Policy

Therapeutic Area Preventive Cardiology Best Practices – clinic operations, team approaches, outcomes research Background Rural areas in the U.S. face a disproportionate burden of atherosclerotic cardiovascular disease (ASCVD) and face limited access to specialist care. Because specialists more commonly prescribe novel therapies, this can also impact access to new medications. In this study, we sought to examine rural-urban differences in the presence and characteristics of prescribers of novel lipid lowering therapies (LLT). Methods This cross-sectional study analyzed pharmacy transaction data from Symphony Health Solutions (2018–2022) for all prescriptions of any lipid lowering therapy. Prescribers were identified from the Symphony database and cross-matched with their National Provider Identifier number. Prescriber address was linked to census tract-level data, which were classified as rural or urban based on Health Resources and Services Administration definitions. At the census-tract level, the presence of prescribers for novel LLTs overall and by prescriber specialty was assessed. Results Among 85,396 census tracts (20.3% rural), 62.9% had at least one prescriber of LLT, including 66.7% of urban and 59.7% of rural census tracts. Of these with any LLT prescriber, at least one prescriber of novel LLT (PCSK9i or Bempedoic acid) was present in 42.7% of rural census tracks and 36% of urban census tracks. In urban areas, 67.7% of cardiology LLT prescribers and 50.2% of primary...