Medical Expenditure Panel Survey 

Agency for Healthcare 

Research and Quality 

STATISTICAL BRIEF #97 

September 2005 

Trends in Statin Use in the Civilian 

Noninstitutionalized Medicare 

Population, 1997 and 2002 

G. Edward Miller, PhD and Marie N. Stagnitti, MPA 

Introduction 

Statins are prescribed medications that are used to lower levels of 

cholesterol and other fats in the blood. This may help prevent 

medical problems caused by cholesterol clogging the blood vessels.1 

The first drug in this class, lovastatin (Mevacor), was approved by 

the U.S. Food and Drug Administration in 1987 and was followed by 

five other statins that were approved between 1991 and 1997. Use 

of these drugs has increased rapidly since their introduction. By 

2002, atorvastatin (Lipitor), simvastatin (Zocor), and pravastatin 

(Pravachol) ranked first, second, and third, respectively, in total 

expenditures among drugs purchased by the U.S. civilian 

noninstitutionalized elderly population.2 

This Statistical Brief presents data from the Household Component 

of the Medical Expenditure Panel Survey (MEPS-HC) on statin use 

in the U.S. civilian noninstitutionalized Medicare population in 1997 

and 2002. Estimates are presented for subgroups of the Medicare 

population defined by age, race/ethnicity, sex, poverty status, 

insurance status, and health status. All differences discussed in the 

text are statistically significant at the 0.05 level. 

Findings 

In 1997, 11.6 percent of the 38.0 million persons in the civilian 

noninstitutionalized Medicare population used at least one statin 

during the year. By 2002, the Medicare population had grown to 41.1 

million persons, and the proportion of persons using a statin had 

increased to 27.1 percent. (figure 1) As a result, the number of statin 

users in the Medicare population increased from 4.4 million in 1997 

to 11.1 million in 2002. 

Rapid increases in the use of statins were widespread. From 1997 to 

2002, the proportion of beneficiaries who used at least one statin 

1 Medline Plus http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202284.html 2 Stagnitti, M. N. Top 10 Outpatient Prescription Medicines Ranked by Utilization and Expenditures for the Elderly in the U.S. 

Community Population, 2002. Statistical Brief #66. February 2005. Agency for Healthcare Research and Quality, Rockville, Md. 

Highlights 

¢ The proportion of the civilian 

noninstitutionalized Medicare 

population using statins increased from 11.6 percent in 

1997 to 27.1 percent in 2002. 

¢ From 1997 to 2002, the 

proportion of beneficiaries 

who used at least one statin 

during the year more than 

doubled for both men and 

women and for all age, insurance status, and health 

status categories examined. 

¢ Among beneficiaries who 

reported that they were in 

excellent health, the proportion with statin use more than 

tripled, from 5.6 per-cent in 

1997 to 20.0 percent in 2002. 

¢ From 1997 to 2002, statin use 

increased for Hispanic beneficiaries from 10.9 to 18.2 

percent, for white non-Hispanic beneficiaries from 12.3 

to 28.5 percent, and for black 

non-Hispanic beneficiaries 

from 6.9 to 20.7 percent. 

¢ Statin use also increased 

across all poverty categories 

from 1997 to 2002: from 9.7 

to 22.5 percent for the poor/ 

near poor, 9.2 to 27.8 percent 

for those with low incomes, 

13.9 to 27.4 percent for those 

with middle incomes, and 

12.0 to 29.3 percent for those 

with high incomes. 
during the year more than doubled for both men and women and for all age, insurance status, and 

health status categories examined. There were also large increases in statin use in all race/ethnicity 

and poverty categories. There were only two groups—Hispanics and middle income beneficiaries—for 

whom the proportion with use did not at least double. 

There were increases in statin use by both male and female beneficiaries from 1997 to 2002. The 

proportion with use increased from 11.8 to 29.6 percent for males and from 11.5 to 25.1 percent for 

females. (figure 2) 

Statin use increased for non-elderly beneficiaries (those under age 65) from 7.1 percent in 1997 to 16.9 

percent in 2002. Increased use was also observed for all three age categories of elderly beneficiaries: 

age 65–74 (14.6 versus 30.9 percent), age 75–84 (10.6 versus 30.5 percent), and 85 years old and 

older (4.5 versus 11.8 percent). (figure 3) 

From 1997 to 2002, the proportion of black non-Hispanic beneficiaries using statins tripled, rising from 

6.9 to 20.7 percent. For white non-Hispanic beneficiaries, the percentage with use more than doubled 

from 12.3 to 28.5 percent; and for Hispanic beneficiaries, the proportion with use rose by about twothirds, from 10.9 to 18.2 percent. (figure 4) 

Statin use more than doubled from 1997 to 2002 for beneficiaries with each type of supplementary 

insurance. For beneficiaries with a private group policy, use increased from 14.1 to 32.4 percent; and 

for beneficiaries with a private non-group policy, use increased from 11.0 to 26.4 percent. For 

beneficiaries with public insurance in addition to Medicare, use increased from 7.9 to 17.4 percent. 

Finally, for beneficiaries who were enrolled in a Medicare HMO or who had Medicare fee-for-service 

coverage only, use increased from 10.3 to 25.1 percent. (figure 5) 

Statin use among Medicare beneficiaries increased for all poverty status classifications when 

comparing the years 1997 and 2002. Statin use increased from 9.7 to 22.5 percent for the poor/near 

poor, from 9.2 to 27.8 percent for those with low incomes, from 13.9 to 27.4 percent for those with 

middle incomes, and from 12.0 to 29.3 percent for those with high incomes. (figure 6) 

Among beneficiaries who reported that they were in excellent health, the proportion with statin use 

more than tripled, from 5.6 percent in 1997 to 20.0 percent in 2002. Statin use also increased for 

beneficiaries reporting good/very good health (13.6 versus 29.1 percent) and beneficiaries reporting 

fair/poor health (11.1 versus 27.3 percent). (figure 7) 

Data Source 

The estimates presented in this Statistical Brief were derived from the 1997 and 2002 full-year 

consolidated data files and the 1997 and 2002 MEPS prescribed medicines (PMED) files. Statins were 

identified by linking the PMED files to the Multum Lexicon. Individuals were classified as using statins if 

they had one or more purchases of these drugs during the year. 

Definitions 

Use 

Use was defined as one or more purchases of a prescribed statin medicine. The group of drugs 

commonly known as statins is more formally referred to as 3-hydroxy-3-methylglutaryl coenzyme A 

(HMG-CoA) reductase inhibitors.1 This brief focuses solely on this class of drugs. Other cholesterollowering drugs, such as fibric acid derivatives and bile acid sequestraints, were not included. For this 

brief, statins were determined by using the Multum Lexicon therapeutic classification variables from 

Cerner Multum, Inc. Statins were defined as those prescribed drugs in the Multum Lexicon therapeutic 

sub-class, HMG-CoA Reductase Inhibitors. 

Medicare population 

Individuals were included in the Medicare population if they reported Medicare coverage in at least one 

month during the year. A small number of persons 65 and older never reported Medicare coverage 

during the year. These persons were excluded from the analysis. 
Age 

Age is the last available age for the sampled person. For most persons, this was their age at the end of 

the year. 

Racial and ethnic classifications 

Classification by race and ethnicity was based on information reported for each family member. 

Respondents were asked if each family member's race was best described as American Indian, Alaska 

Native, Asian or Pacific Islander, black, white, or other. They also were asked if each family member's 

main national origin or ancestry was Puerto Rican; Cuban; Mexican, Mexicano, Mexican American, or 

Chicano; other Latin American; or other Spanish. All persons whose main national origin or ancestry 

was reported in one of these Hispanic groups, regardless of racial background, were classified as 

Hispanic. Since the Hispanic grouping can include black Hispanic, white Hispanic, Asian and Pacific 

Islanders Hispanic, and other Hispanic, the race categories of black, white, Asian and Pacific Islanders, 

and other do not include Hispanic. Beginning in 2002, MEPS respondents were allowed to report 

multiple races, and these persons were included in the other non-Hispanic category. As a result, there 

was a slight increase in the percentage of persons classified in this category in 2002 compared with 

prior years. 

Health insurance status 

Respondents were asked about health insurance coverage for themselves and all household members 

at each round of interviewing. The insurance variables reflect supplemental coverage, in addition to 

Medicare, that beneficiaries had for hospital and physician services. Persons categorized as having 

supplemental insurance coverage may or may not have coverage for prescription drugs. The insurance 

categories are mutually exclusive and hierarchical. Persons with more than one type of supplemental 

coverage were placed into an insurance category in the following order: 

– Private group insurance: This group includes those who, at any time in the survey year, had group 

plan coverage for medical or related expenses. It also includes persons who were covered by 

CHAMPUS/TRICARE (which covers retired members of the uniformed services and the spouses and 

children of active-duty military). 

– Private non-group: This group includes those who at any time in the survey year had individually 

purchased private coverage for medical or related expenses. The private group and non-group 

definitions both include prepaid health plans (such as health maintenance organizations) but exclude 

extra cash coverage plans, medical benefits linked only to specific diseases (dread disease plans), 

and casualty benefit plans (such as automobile insurance). 

– Other public insurance: This group includes those who at any time in the survey year had coverage 

from Medicaid or other State and local medical assistance programs. 

– Medicare HMO/Medicare only: This group includes persons who did not report any private or public 

supplemental insurance coverage and were enrolled in Medicare HMOs or had Medicare fee-forservice coverage only. 

Poverty status 

Each year, persons were classified according to their family’s income in terms of poverty status. In this 

report, poverty status is the ratio of the family’s income to the Federal poverty thresholds, which control 

for the size of the family and the age of the head of the family. The following classification of poverty 

status was used: 

– Poor/near poor: Persons in families with income of 125 percent of the poverty line or less, including 

those who reported negative income. 

– Low income: Persons in families with income from over 125 percent through 200 percent of the 

poverty line. 

– Middle income: Persons in families with income from over 200 percent through 400 percent of the 

poverty line. 

– High income: Persons in families with income over 400 percent of the poverty line. 

Perceived health status 

During each round of interviewing, the household respondent was asked to rate the health of each 

person in the family according to the following categories: excellent, very good, good, fair, or poor. For 

this report, the response categories “very good” and “good” were collapsed, as were “fair” and “poor.” 

Health status was missing for approximately 1 percent of beneficiaries. 
About MEPS-HC 

MEPS-HC is a nationally representative longitudinal survey that collects detailed information on health 

care utilization and expenditures, health insurance, and health status, as well as a wide variety of 

social, demographic, and economic characteristics for the civilian noninstitutionalized population. It is 

cosponsored by the Agency for Healthcare Research and Quality and the National Center for Health 

Statistics. 

For more information about MEPS, call the MEPS information coordinator at AHRQ (301-427-1656) or 

visit the MEPS Web site at http://www.meps.ahrq.gov/. 

References 

For a detailed description of the MEPS survey design, sample design, and methods used to minimize 

sources of nonsampling error, see the following publications: 

Cohen, J. Design and Methods of the Medical Expenditure Panel Survey Household Component. 

MEPS Methodology Report No. 1. AHCPR Pub. No. 97-0026. Rockville, Md.: Agency for Health Care 

Policy and Research, 1997. 

Cohen, S. Sample Design of the 1996 Medical Expenditure Panel Survey Household Component. 

MEPS Methodology Report No. 2. AHCPR Pub. No. 97-0027. Rockville, Md.: Agency for Health Care 

Policy and Research, 1997. 

Cohen, S. Design Strategies and Innovations in the Medical Expenditure Panel Survey. Medical Care, 

July 2003: 41(7) Supplement: III-5–III-12. 

Suggested Citation 

Miller, G. E. and Stagnitti, M. N. Trends in Statin Use in the Civilian Noninstitutionalized Medicare 

Population, 1997 and 2002. Statistical Brief #97. September 2005. Agency for Healthcare Research 

and Quality, Rockville, Md. http://www.meps.ahrq.gov/papers/st97/stat97.pdf 

� � �

AHRQ welcomes questions and comments from readers of this publication who are interested in 

obtaining more information about access, cost, use, financing, and quality of health care in the United 

States. We also invite you to tell us how you are using this Statistical Brief and other MEPS data and 

tools and to share suggestions on how MEPS products might be enhanced to further meet your needs. 

Please e-mail us at mepspd@ahrq.gov or send a letter to the address below: 

Steven B. Cohen, PhD 

Director 

Center for Financing, Access, and Cost Trends 

Agency for Healthcare Research and Quality 

540 Gaither Road 

Rockville, MD 20850 
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1997 and 2002.

11.6

27.1

0

10

20

30

40

1997 2002

Figure 1. Percentage of the Medicare population with

at least one statin purchase, 1997 and 2002

P

ercent

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1997 and 2002.

11.5 11.8

29.6

25.1

0

10

20

30

40

Male Female

1997 2002

Figure 2. Percentage of the Medicare population with

at least one statin purchase, by sex, 1997 and 2002

P

ercent
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1997 and 2002.

11.8

4.5

10.6

14.6

7.1

30.5

16.9

30.9

0

10

20

30

40

Less than 65 65-74 75-84 85 and older

1997 2002

Figure 3. Percentage of the Medicare population with

at least one statin purchase, by age, 1997 and 2002

P

ercent

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1997 and 2002.

28.5

12.3

6.9

10.9

18.2

20.7

0

10

20

30

40

Hispanic Black non-Hispanic White non-Hispanic

1997 2002

Figure 4. Percentage of the Medicare population with at

least one statin purchase, by race/ethnicity, 1997 and 2002

P

ercent
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1997 and 2002.

17.4

25.1

10.3

7.9

11.0

14.1

32.4

26.4

0

10

20

30

40

Private group Private non-group Public Medicare HMO/

Medicare only

1997 2002

Figure 5. Percentage of the Medicare population with at least

one statin purchase, by supplementary insurance status,

1997 and 2002

P

ercent

Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1997 and 2002.

27.4

29.3

12.0 13.9

9.2 9.7

22.5

27.8

0

10

20

30

40

Poor/near poor Low income Middle income High income

1997 2002

Figure 6. Percentage of the Medicare population with at

least one statin purchase, by poverty status, 1997 and 2002

P

ercent
Source: Center for Financing, Access, and Cost Trends, AHRQ, Household Component of the Medical Expenditure Panel Survey, 

1997 and 2002.

27.3

11.1

13.6

5.6

20.0

29.1

0

10

20

30

40

Excellent Good/very good Fair/poor

1997 2002

Figure 7. Percentage of the Medicare population with at

least one statin purchase, by perceived health status,

1997 and 2002

P

ercent