A retrospective analysis on the use of gemfibrozil in general outpatient clinics

Abstract

Objective: To assess the current use of lipid lowering medication in general outpatient clinics (GOPCs) and explore the need for introduction of alternative modalities of treatment. Design: Retrospective analysis. Subjects: All patients prescribed with gemfibrozil in New Territories Cluster's GOPCs. Main outcome measures: Pre-treatment cardiovascular disease risk levels according to Joint British Societies cardiovascular disease risk charts, pre-treatment triglyceride (TG) levels. Results: 1157 patients were prescribed with gemfibrozil over the eight weeks of data collection. 15% did not have any pre-treatment TG levels. Only 13.1% fit pretreatment criteria for initiating gemfibrozil. 43% of those taking gemfibrozil have co-existing atherosclerotic disease or diabetes warranting the use of alternative lipid lowering therapy. On the one hand, the current daily cost of inappropriate prescription of gemfibrozil in these 1157 patients is HK$853. On the other hand, statins at a cost of HK$2.38 per dose would result in cost neutrality with an expected improvement in cardiovascular disease risk in the same group of patients. Conclusions: This study has highlighted the overuse of gemfibrozil for a population who may benefit from alternative therapy.