This measure assesses the percentage of members 40–75 years of age with diabetes who do not have clinical atherosclerotic cardiovascular disease (ASCVD) who met the following criteria. Two rates are reported:
- Received Statin Therapy. Members who were dispensed at least one statin medication of any intensity.
- Statin Adherence 80%. Members who remained on a statin medication of any intensity for at least 80% of the treatment period.
Why it Matters
Diabetes is a complex group of diseases marked by high blood sugar due to the body’s inability to make or use insulin. Diabetes can lead to serious complications.1 Thirty-eight million (11.6%) Americans had diabetes in 2021, and 1.2 million adults were newly diagnosed with diabetes.2Patients with diabetes have elevated cardiovascular risk due in part to elevations in unhealthy cholesterol levels. Having unhealthy cholesterol levels places patients at a significant risk for developing ASCVD.3
Primary prevention for cardiovascular disease is an important aspect of diabetes management. The risk of an adult with diabetes developing cardiovascular disease is two times higher than that of an adult without diabetes.4 In addition to being at a higher risk for developing cardiovascular disease, patients with diabetes tend to have worse survival after the onset of cardiovascular disease.5 The CDC estimates that adults with diabetes are 1.7 times more likely to die from cardiovascular disease than adults without diabetes.1
Numerous studies have demonstrated the efficacy of statins in reducing cardiovascular risk. The use of statins for primary prevention of cardiovascular disease in patients with diabetes, based on their age and other risk factors, is recommended by guidelines from the American Diabetes Association (ADA) and the American College of Cardiology/American Heart Association (ACC/AHA). Cholesterol lowering medications, such as statins, are among the most commonly prescribed drugs in America, accumulating $17B in sales in 2012. In the United States, 22% of adults (45 and older) take statins.1 Evidence shows statin use decreases cardiovascular mortality in patients with established cardiovascular disease, and total mortality rates. Primary and secondary prevention trial data strongly support starting lipid-lowering therapy with a statin in most patients with type 2 diabetes.6
Historical Results – National Averages
Statin Therapy for Patients With Diabetes – Received Statin Therapy
| Measurement Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2022 | 65.4 | 63.3 | 63.8 | 79.2 | 77 |
| 2021 | 66.1 | 64.5 | 64.7 | 79 | 76.6 |
| 2020 | 65.1 | 63.8 | 64.3 | 77.9 | 75.2 |
| 2019 | 64.0 | 62.5 | 64.0 | § | § |
| 2018 | 63.0 | 61.0 | 62.3 | 74.4 | 71.3 |
| 2017 | 61.5 | 60.1 | 61.4 | 72.3 | 69.6 |
| 2016 | 60.2 | 58.9 | 60.2 | 70.7 | 67.8 |
Statin Therapy for Patients With Diabetes – Received Statin Therapy
| Measurement Year | Commercial HMO | Commercial PPO | Medicaid HMO | Medicare HMO | Medicare PPO |
|---|---|---|---|---|---|
| 2023 | 72.6 | 77.5 | 67.4 | 84.9 | 85.1 |
| 2022 | 72 | 76.7 | 66.1 | 83.8 | 84.3 |
| 2021 | 72.5 | 76 | 66.2 | 82.8 | 83.6 |
| 2020 | 73.4 | 76.5 | 68.7 | 83.8 | 85.3 |
| 2019 | 70.4 | 73.5 | 64.1 | § | § |
| 2018 | 70.1 | 71.0 | 61.1 | 78.4 | 79.7 |
| 2017 | 66.5 | 67.7 | 59.0 | 74.0 | 75.2 |
| 2016 | 66.5 | 67.5 | 59.3 | 75.3 | 77.6 |
§ Not available due to CMS suspension of data reporting during COVID-19 pandemic.
This State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.
Figures do not account for changes in the underlying measure that could break trending. Contact Information Products via my.ncqa.org for analysis that accounts for trend breaks.
References
- Centers for Disease Control and Prevention (CDC). 2014. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services.
- Centers for Disease Control and Prevention (CDC). 2023. National Diabetes Statistics Report. Atlanta, GA: US Dept of Health and Human Services. https://www.cdc.gov/diabetes/data/statistics-report/index.html
- ADA. 2020. “Cardiovascular Disease and Risk Management: Standards of Medical Care I Diabetes–2020.” Diabetes Care 43(Suppl. 1): S111-S134. doi: 10.2337/dc20-s010
- American Heart Association (AHA). 2021. Cardiovascular Disease and Diabetes. May 4, 2021. https://www.heart.org/en/health-topics/diabetes/diabetes-complications-and-risks/cardiovascular-disease–diabetes
- Stone, N.J., J. Robinson, A.H. Lichtenstein, et al. 2013. “2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults.” J Am Coll Cardiol 63(25 Pt B):2889–934. doi: 10.1016/j.jacc.2013.11.002. Epub 2013 Nov 12.
- Spratt, K.A. 2009. “Managing Diabetic Dyslipidemia: Aggressive Approach.” J Am Osteopath Assoc 109(5 Suppl): S2-7. http://www.jaoa.org/cgi/content/full/109/5_suppl_1/S2