Quality and efficiency of statin prescribing across countries with a special focus on South Africa : findings and future implications

Godman, Brian and Bishop, Iain and Campbell, Stephen M and Malmström, Rickard E and Truter, Ilse (2015) Quality and efficiency of statin prescribing across countries with a special focus on South Africa : findings and future implications. Expert Review of Pharmacoeconomics and Outcomes Research, 15 (2). pp. 323-330. ISSN 1473-7167

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    Abstract

    Statins are recommended first-line treatment for hyperlipidemia, with published studies suggesting limited differences between them. However, there are reports of under-dosing. South Africa has introduced measures to enhance generic utilization. Part one documents prescribed doses of statins in 2011. Part two determines the extent of generics versus originator and single-sourced statins in 2011 and their costs. Results: Underdosing of simvastatin in 2011 with average prescribed dose of 23.7 mg; however, not for atorvastatin (20.91 mg) or rosuvastatin (15.02 mg). High utilization of generics versus originators at 93–99% for atorvastatin and simvastatin, with limited utilization of single-sourced statins (22% of total statins – defined daily dose basis), mirroring Netherlands, Sweden and UK. Generics priced 33–51% below originator prices. Discussion: Opportunity to increase simvastatin dosing through education, prescribing targets and incentives. Opportunity to lower generic prices with generic simvastatin 96–98% below single-sourced prices in some European countries.