Abstract

Substituting brand-name medications with generic equivalents provides lower cost options for patients and can mitigate drug expenditures. Brand-name atorvastatin was the most frequently prescribed brand-name statin until generic was available in the United States on 11/30/2011. The objective of our study was to examine frequency and time to conversion to generic atorvastatin for patients who were on brand-name atorvastatin or other statins. We identified Medicare beneficiaries with any new statin prescriptions between 1/1/2007 and 11/30/2011 using the Chronic Conditions Data Warehouse 5% sample. Continuous enrollment in Medicare Parts A, B, and D for a minimum of 12 months prior to initial statin prescription and through 2012 was required. Users who switched statin type before, or did not refill after 11/30/2011, were excluded. Users were followed through 2015 or until censoring/death. We examined the proportion of statin users who switched to generic atorvastatin and the number of refills before switching. Of 43,307 statin users who met the eligibility criteria, 12,660 (29%) switched to generic atorvastatin after 11/30/2011 versus remaining on their current statin. 89% of brand-name atorvastatin users (n=5,420) switched within 1.8 refills on average, followed by 21% of both simvastatin (n=4,883) and brand-name rosuvastatin (n=863) users within 4.8 and 4.9 refills, respectively, and 15% of pravastatin users (n=1,058) within 4.5 refills. The availability of generic atorvastatin resulted in switching among the vast majority of brand-name atorvastatin users and among other statins but at a slower rate. The rapid rate of switching among Lipitor users was likely due to Medicare policy and pharmacies’ ability to substitute automatically to a generic without consulting a prescriber. Brand-name rosuvastatin’s lack of generic availability and simvastatin’s high-intensity dose restriction may have also contributed to switching. Future research should consider how these trends relate to statin expenditures and other effects such as adherence.

Full Text
Published version (Free)

Talk to us

Join us for a 30 min session where you can share your feedback and ask us any queries you have

Schedule a call