Statin cost-effectiveness comparisons using real-world effectiveness data: formulary implications.
OBJECTIVE
To compare the effectiveness and cost-effectiveness among generic and branded statins in routine clinical practice.


METHODS
Retrospective database study of patients, 18+, who were newly prescribed statin therapy. Statin effectiveness and cost-effectiveness in reducing low-density lipoprotein cholesterol (LDL-C) and attaining LDL-C goals were evaluated.


RESULTS
Of 10,421 eligible patients, % LDL-C reduction was significantly greater (P < 0.001) with rosuvastatin (-31.6%) than other statins (-13.9 to -21.9%). Percentage of patients at moderate/high risk attaining LDL-C goal was higher (P < 0.001) for rosuvastatin (76.1%) versus other statins (57.6-72.6%). Rosuvastatin was more effective and less costly than atorvastatin. Among generic statins, simvastatin required >61% discount to branded price to achieve similar cost-effectiveness as generic lovastatin.


CONCLUSIONS
In clinical practice, rosuvastatin is more effective and less costly in lowering LDL-C and LDL-C goal attainment compared with atorvastatin. Simvastatin was more cost-effective compared with lovastatin if >61% discount to branded price was achieved.
Ohsfeldt
Robert L
RL
Texas A&M Health Science Center, College Station, TX 77843-1266, USA. rohsfeldt@srph.tamhsc.edu
Gandhi
Sanjay K
SK
Fox
Kathleen M
KM
McKenney
James M
JM
D000368:Aged; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood; D003362:Cost-Benefit Analysis; D016568:Drugs, Generic / Q000191:economics* / Q000627:therapeutic use; D005260:Female; D005464:Fluorobenzenes / Q000191:economics / Q000627:therapeutic use; D006538:Heptanoic Acids / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000188:drug therapy; D008148:Lovastatin / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000191:economics / Q000627:therapeutic use; D011758:Pyrroles / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000191:economics / Q000627:therapeutic use; D013449:Sulfonamides / Q000191:economics / Q000627:therapeutic use
D008078:Cholesterol, LDL; D016568:Drugs, Generic; D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D008148:Lovastatin; D000069059:Atorvastatin; D019821:Simvastatin