Disparities among the disadvantaged: Variation in lipid management in the Ohio Medicaid program

Background. Racial disparities exist in cardiovascular disease (CVD) prevention, but other non-clinical factors may influence treatment, further exacerbating disparities. Methods. Using Ohio Medicaid data from 1992 to 1999, we identified a sample of 19,106 individuals with CVD-related diagnoses or procedures. A review of pharmacy claims identified previous, new, and long-term users of lipid-lowering agents, including statins, fibrates, and bile sequestrants. Results. 3934 (20.6%) Medicaid beneficiaries used lipid-lowering medications previously, 1598 (10.5%) filed new claims, and 2998 of 5532 (54.2%) previous or new users filed ≥6 claims for refills. Minority adults ≤60 years were least likely to have been previous users (0.80 [0.67, 0.96]), new users (0.75 [0.58, 0.98]), or to use lipid-lowering agents long-term (0.65 [0.49, 0.84]). Conclusions. Targeted efforts to enhance younger minority adultsʹ receipt and long-term use of lipid-lowering agents may reduce risks for subsequent morbidity and mortality related to CVD.