Abstract
BackgroundIn 2011, Manitoba implemented a province-wide program of physician detailing and free sampling for generic atorvastatin to increase use of this generic statin. We examined the impact of this unique combined program of detailing and sampling for generic atorvastatin on the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin.MethodsWe conducted a retrospective study of Manitoba insurance claims data for all continuously enrolled patients who filled one or more prescriptions for a statin between 2008 and 2013. Data were linked to physician-level data on the number of detailing visits and sample provision. We used interrupted time series analyses to assess policy-related changes in the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin.ResultsThe detailing program reached 31% (651/2103) of physicians who prescribed a statin during the study period. Collectively, these physicians prescribed 61% of statins dispensed in the province. Free sample cards were provided to 61% (394/651) of the detailed physicians. The program did not change the level or trend in the overall statin use rate and the total cost of statins or increase the number of patients switching from another branded statin to generic atorvastatin. We found the program had a small impact on atorvastatin’s market share of new prescriptions, with a level increase of 2.6%.ConclusionsThough physician detailers were skilled at targeting high-prescribing physicians, a combined program of detailing visits and sample provision for generic atorvastatin did not lower overall statin costs or lead to switching from branded statins to the generic. The preceding introduction of generic atorvastatin appeared sufficient to modify prescribing patterns and decrease costs.
Highlights
In 2011, Manitoba implemented a province-wide program of physician detailing and free sampling for generic atorvastatin to increase use of this generic statin
As there are no rigorous data on the efficacy of a combined program of detailing visits and sample provision on generic drug use, we studied the impact of the program
In exchange for this exclusive listing, Ranbaxy initiated a program of physician detailing and free sampling, which started in June 2011
Summary
In 2011, Manitoba implemented a province-wide program of physician detailing and free sampling for generic atorvastatin to increase use of this generic statin. We examined the impact of this unique combined program of detailing and sampling for generic atorvastatin on the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin. One important cost-saving opportunity is increasing the use of cheaper (but therapeutically interchangeable) generic alternatives [1]. In Canada, each province has Worthington et al Implementation Science (2017) 12:141 the major potential for savings, especially as the availability of generic drugs continues to rise [4]. Methods are employed to increase the use of medicines remaining under patent protection. Many drug programs have attempted to steer physicians toward prescribing the most cost-effective agent using similar tactics of face-to-face visits in the practice of academic detailing, in order to improve both quality and cost effectiveness of care [7]
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