Moving from A to Z: successful implementation of a statin switch program by a large physician group.
OBJECTIVE
To describe the implementation and impact of a centralized statin switch program at a large academic medical center.


METHODS
Patients on atorvastatin were identified from electronic medical records and pharmacy claims data. Relevant information was sent to physicians for approval of the proposed switches. Approved patients were then contacted via phone and offered the opportunity to switch to simvastatin; those who switched received a new prescription for simvastatin. To assess the independent impact of the active switch process, conversion rates within a single insurance plan were compared for patients who participated in this program versus those who were contacted only by mail.


RESULTS
Physicians approved 3207 of the 3677 patients identified for this program. A total of 1710 approved patients accepted the switch, 704 declined, and 170 became ineligible. Information packets were mailed to 623 patients who could not be contacted. Within the single insurance plan, the generic dispensing rate for statins among the 1867 patients included in our program was significantly higher than that for the 2472 patients in the mail-only group (59.2% vs 35.8%, P <.001). Over 8 months, the direct cost of the program was $131,000 with projected annual cost savings of up to $1.14 million to payers and up to $250 for each patient who switched.


CONCLUSIONS
A proactive and voluntary statin switch program to promote the use of a lower cost generic alternative can be successfully implemented in a fee-for-service health system setting with benefits to patients, providers, and payers.
Sy
Fangyan Z
FZ
Quality Management Program, University of Michigan Health System, Ann Arbor, MI 48109, USA.
Choe
Hai Mi
HM
Kennedy
Diane M
DM
Standiford
Connie J
CJ
Parsons
Dawn M
DM
Bruhnsen
Keith D
KD
Stevenson
James G
JG
Bernstein
Steven J
SJ
D000069059:Atorvastatin; D017046:Cost Savings; D016568:Drugs, Generic / Q000191:economics*; D018588:Fee-for-Service Plans; D005260:Female; D006538:Heptanoic Acids / Q000191:economics* / Q000627:therapeutic use; D006784:Hospitals, Teaching; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D008297:Male; D008824:Michigan; D008875:Middle Aged; D018579:Patient Selection; D011758:Pyrroles / Q000191:economics* / Q000627:therapeutic use; D019821:Simvastatin / Q000191:economics* / Q000627:therapeutic use
D016568:Drugs, Generic; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin; D019821:Simvastatin