Patients on Generic Statins Fare Better

By David Douglas

NEW YORK - Medicare beneficiaries on generic statins are more likely to adhere to their therapy and fare better than are those prescribed brand name versions of the drugs, according to a study funded by Teva Pharmaceuticals.

As Dr. Joshua J. Gagne told Reuters Health by email, "Statins are very effective drugs that can lower risk of heart attack and death for some individuals. Patients will only get the full clinical benefit of these drugs if they take them."

While medication adherence is a complex issue, drug cost may be one of the hurdles most easily removed, Dr. Gagne of Brigham and Women's Hospital and Harvard Medical School in Boston and colleagues write in the Annals of Internal Medicine on September 16.

To examine this question, the researchers studied data on Medicare patients with prescription drug coverage between 2006 and 2008.

More than 90,000 patients started a statin during the study. In all, 93% initiated use of a generic (lovastatin, pravastatin, or simvastatin) and the remaining 7% were prescribed a brand name drug. The average copayment for the index statin prescription was $10 for those who got a generic and $48 for those on a brand name drug.

Adherence to statin therapy as measured by the proportion of days covered for up to a year was 77% in the generic group, significantly greater than the 71% seen in the brand-name group.

The finding, says the team, "is consistent with other studies that have shown a direct relation between higher copayments and lower adherence."

In addition, in the generic group there was a significant 8% reduction in a composite outcome comprising hospitalization for an acute coronary syndrome or stroke and all-cause mortality (hazard ratio, 0.92).

"Our study found that using generic statins instead of more costly brand-name versions results in better adherence and better health outcomes," Dr. Gagne concluded.

The researchers note that since their study, additional generic statins have become available, which may have increased use.

"Although these findings require confirmation in other populations, they add to our understanding of the comparative effectiveness of generic medications and the importance of economic factors in medication adherence," Dr. Walter Cullen of University College Dublin in Ireland and colleagues point out in an accompanying editorial.

SOURCE: https://bit.ly/1wnI7tV and https://bit.ly/1r3D2XA

Ann Intern Med 2014;16:400-407, 447-448.

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