The use of cardiovascular drugs has increased so dramatically in Canada that costs associated with the medications have jumped 200 per cent in a decade, new research suggests.

The study, published in the Canadian Medical Association Journal, put the total cost of cardiovascular drugs in 2006 at more than $5 billion. Statins, which lower cholesterol, accounted for nearly 40 per cent of those costs.

According to the researchers, cardiovascular disease is the leading cause of premature death and disability in Canada, and cardiovascular drugs are the most commonly prescribed medications.

If the pace continues, the researchers warned, costs could spiral to $10.6 billion by 2020 and could threaten the viability of government-funded drug insurance programs.

"This rapid escalation in costs for cardiovascular drugs threatens the sustainability of public drug insurance programs," the authors wrote. "Increases of this magnitude over such a relatively short period deserve further scrutiny."

The researchers, who hailed from a number of institutions across Canada, cited various factors that contributed to the growth in expenditures: an aging, and growing, population; increasing rates of hypertension; and rising drug costs.

However, other factors may explain the increase, including the use of new, and more expensive, cardiovascular medications.

According to the study, the medication classes that had the highest increases in the number of prescriptions were:

  • angiotensin receptor blockers
  • antiplatelets
  • statins
  • ACE inhibitors

Many of the prescriptions associated with these medications were for brand name drugs, where older, cheaper drugs could still be used, the researchers said.

"Projected increases may reach potentially unsustainable levels," the authors wrote. "Greater emphasis on the use of cost- effective medications is required to limit further increases."

Dr Robert Califf of Duke University Medical Center said the findings ignore the fact that the drugs included in the study reduce the risk of death and disability in patients with cardiovascular disease. Therefore, the increased use of these drugs means more lives are being saved.

"Determining the right level of medication use depends critically on the balance of total societal costs and health outcomes. This consideration is missing from the report...," Califf wrote in an editorial that accompanied the study.

"If greater use of cardiovascular medications controls blood pressure and lipid levels while also slowing progression of kidney disease and preventing adverse arterial and myocardial remodeling, then the cost of medications could easily be offset by a reduction in hospital admissions. Alternatively, the higher cost might result in a health benefit that would be considered well worth the incremental cost."