Effect of Financial Incentives to Physicians, Patients, or Both on Lipid Levels

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Abstract
Cardiovascular disease (CVD) is the leading cause of death in the United States, and clinical trials indicate that taking statins (HMG-CoA reductase inhibitors) to lower cholesterol reduces the risk of myocardial infarction by about 30%.1 Despite proven benefits, the relatively low cost, once-a-day dosing, and few adverse effects, the population effectiveness of statins is limited for 2 reasons. First, physicians underprescribe statins or fail to intensify treatment when indicated.2,3 Second, approximately half of patients prescribed statins discontinue usage within a year, even among those surviving acute coronary syndromes.4-6 Poor adherence is associated with worse outcomes, higher hospitalization and mortality rates, and increased health care costs among patients with CVD.4,5,7-9

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