Nonadherence to LLT associated with higher healthcare resource utilization and costs in a large integrated healthcare delivery system in Southern California.

Guideline-recommended lipid-lowering therapy (LLT) can reduce healthcare utilization and costs for patients with and at-risk for atherosclerotic cardiovascular disease (ASCVD). We examined healthcare utilization and associated costs among adult LLT users in Kaiser Permanente Southern California ≥21 years of age having ASCVD or intermediate (≥7.5% to <20%) or high (≥20%) 10-year ASCVD risk between 2015 and 2021. LLT adherence trajectories were determined using group-based trajectory modeling over 12 months. All-cause and ASCVD-related annualized adjusted costs were calculated through 2023. High versus low LLT adherence was associated with lower all-cause costs (-$999; 95% CI: -$1100, -$897) and varied across subgroups by ASCVD risk. Adults missing a follow-up low-density lipoprotein cholesterol (LDL-C) measure had +$8312 (95% CI +$7955, +$8669) higher all-cause costs compared to adults with LDL-C < 55 mg/dL. Improving LDL-C management through optimized LLT treatment strategies can reduce economic burdens in high-risk patients.