Inequity in Access of Statins in Iran: A Panel Study Using Provincial Data

Statins are among useful drug to prevent hyperlipidemia and subsequent cardiovascular diseases. Having an equal access to these drugs are very important for health policy makers. Provincial data of statin supply for Iran in 2013 were used in this study. Concentration index, GINI coefficient, concentration curve and Lorenz curve were calculated to show the level of inequality in access of statins. The percentage of population more than 65 years old was used as the need index. A panel data regression was used to estimate the contributing factors of inequality. GINI index was 0.297 for lovastatin, 0.322 for atorvastatin and 0.526 for simvastatin. GINI index for overall statin use was 0.303. Concentration index was not significant for atorvastatin and simvastatin while it was 0.160 for lovastatin. The coefficient of income was -1.75 for lovastatin, 1.04 for atorvastatin and -1.117 for simvastatin. The regression model showed that household income was independently contributed to decrease in Lovastatin (B = -1.752) and Simvastatin (B = -1.118) and increase in Atorvastatin (B = 1.04) access. Higher percentage of people with academic education, the number of physician, and price of drug were another significant predictors of statin access. The inequality for access in Simvastatin was greater than other statins. Household income and price of drug were among important contributors of statin access. For increasing access to statins it is suggested to increase the coverage of health insurance.