Prescribing Practice and Direct Cost of Lipid Lowering Agents in Selected Private Health Care Center of Pokhara Metropolitan, Nepal

Introduction: Lipid-lowering agents (LLAs) are essential for cardiovascular risk management, but prescribing practices and costs impact treatment accessibility in Nepal. This study evaluates LLA prescribing practice, and direct costs in private healthcare settings. Methods: A cross-sectional study analyzed 325 consecutive prescriptions containing LLAs from two private centers in Pokhara (July-December 2018) using WHO prescribing indicators. Data on demographics, lipid profiles, and costs were analyzed using SPSS v16. Results: Among 325 patients (54.5% female, mean age 57.14±13.01 years), mean lipid levels showed borderline high triglycerides (187.47±62.63 mg/dL) despite desirable total cholesterol (172.66±32.91 mg/dL). Hypertension (35.4%) was the primary indication. Atorvastatin (49.8%) and Rosuvastatin (47.1%) dominated prescriptions, with significant polypharmacy (4.53±1.56 drugs/prescription). Critical gaps included minimal generic prescribing (1.27%) and suboptimal essential medicine use (27.22%). Rosuvastatin 20mg was the costliest agent (NRs 1,033.40±227.15/month), contributing to a mean daily LLA cost of NRs 13.22±1.96. Only 57.8% of patients demonstrated adequate medication understanding. Conclusion: While statins remain first-line therapy, irrational practices (low generics, high polypharmacy) and significant cost variations highlight urgent needs for prescription audits, essential medicine compliance, and cost-saving substitutions to optimize dyslipidemia management in Nepal.