Frequency and geographical distribution of PCSK9 inhibitors prescription in Colombia between 2019 and 2021

Introduction and objectives: Proprotein convertase subtilisin/kexin type 9 convertase inhibitors (iPCSK9) effectively reduce low-density lipoprotein cholesterol and have been shown to decrease cardiovascular morbidity and mortality in high-risk patients. However, their cost hinders their real accessibility. This study seeks to describe variables related to iPCSK9 prescription in Colombia. Methods: Population-based analysis of iPCSK9 prescriptions in Colombia during the years 2019-2021, based on data from the government database Sistema Integrado de Información de la Protección Social. Information was extracted on sex, age groups, geographical area (department), health regime, ICD-10 code and the professional profile of the prescriber. Results: There were 7431 prescriptions, 49.5% for alirocumab and 50.5% for evolocumab. Most patients were men > 50 years old. The contributory regimen formulation was higher with a prescription rate ratio of 6.59 (95%CI, 6.147-7.073, P < .01). The most populated areas had the highest prescribing, while six departments had no prescriptions. The most common indications were dyslipidaemia and ischaemic heart disease, with cardiologists and internists being the main prescribers. Conclusions: Formulation of iPCSK9 was lower than expected. There were more formulations in men and people > 50 years, data compatible with the higher incidence of cardiovascular disease in this population group. Regions with higher population density had more formulations and some areas, mainly rural, have no penetration. The marked differences in access between regions and regimens require further analysis to identify possible barriers to access.