title: Behind-the-counter statins: a silver bullet for reducing costs and increasing access?
abstract: OBJECTIVE
  To examine how the 2004 introduction of behind-the-counter (BTC) simvastatin in the United Kingdom affected utilization, prices, and expenditures.
  
  
  METHODS
  Secondary data on simvastatin utilization, prices, and expenditures between 1997 and 2007 in the United Kingdom and four other countries.
  
  
  METHODS
  We used a difference-in-differences approach to estimate how the introduction of BTC simvastatin affected utilization, prices, and expenditures. This approach compares outcomes in the United Kingdom before and after the introduction of BTC simvastatin, using outcomes in countries where the drug remained prescription only to control for possible confounders.
  
  
  METHODS
  Data on simvastain utilization, prices, and expenditures between 1997 and 2007 in the United Kingdom and four other countries were obtained from an outside vendor.
  
  
  RESULTS
  The introduction of BTC simvastatin in the United Kingdom led to a significant increase in utilization of simvastatin and a significant decline in expenditures for simvastatin purchases. Our results are robust to alternate model specifications.
  
  
  CONCLUSIONS
  Behind-the-counter statins have the potential to simultaneously increase use of statins and lower expenditures.
authors.affiliation: Titus Family Department of Clinical Pharmacy and Pharmaceutical Economics and Policy, University of Southern California, Los Angeles, CA 90089, USA. nsood@healthpolicy.usc.edu
authors.forename: Neeraj
authors.initials: N
authors.lastname: Sood
authors.forename: Eric
authors.initials: E
authors.lastname: Sun
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhuo
mesh_terms: D056864:Behind-the-Counter Drugs / Q000191:economics* / Q000600:supply & distribution; D016527:Drug Costs; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics* / Q000600:supply & distribution; D019821:Simvastatin / Q000191:economics* / Q000600:supply & distribution; D006113:United Kingdom
chemical_list: D056864:Behind-the-Counter Drugs; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin
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