Switching statins in Norway after new reimbursement policy: a nationwide prescription study.
OBJECTIVE
To assess the changes in prescribing of statins in Norway after implementation of the new reimbursement regulations for statins in June 2005.


METHODS
Data were retrieved from the Norwegian Prescription Database covering the total population in Norway (4.6 million). Outcome measures were the proportion of atorvastatin users switching to simvastatin and changes in the proportion of new statin users receiving simvastatin. Based on retail costs for all statin prescriptions dispensed in Norway, expenditure was measured in Norwegian currency.


RESULTS
One-year prevalences of statin use increased from 6.3 to 6.8% for women and from 7.5 to 8.1% for men from the year before to the year after the new statin regulations. Of atorvastatin users (N = 131,222), 39% switched to simvastatin during the 13-month period after the implementation. The proportion of switching was higher in women (41%) than in men (36%). In May 2005, 48% of the new statin users received simvastatin. The proportion of new users receiving simvastatin increased rapidly after implementation of the new regulations to 68% in June 2005 and reached 92% in June 2006. Expenditure was reduced from 120 million to 95 million Euro when comparing the year before with the year after the new statin regulations.


CONCLUSIONS
The new reimbursement policy for statins has had a great impact on physicians' prescribing of statins in Norway. Physicians in Norway acknowledge the importance of contributing to cost containment.
Sakshaug
Solveig
S
Department of Pharmacoepidemiology, Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway. solveig.sakshaug@fhi.no
Furu
Kari
K
Karlstad
Øystein
Ø
Rønning
Marit
M
Skurtveit
Svetlana
S
D000069059:Atorvastatin; D016527:Drug Costs / Q000331:legislation & jurisprudence; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006538:Heptanoic Acids / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D009664:Norway / Q000453:epidemiology; D011758:Pyrroles / Q000191:economics* / Q000627:therapeutic use; D012051:Reimbursement Mechanisms / Q000191:economics*; D019821:Simvastatin / Q000191:economics* / Q000627:therapeutic use
D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D019821:Simvastatin