Clinical and economic outcomes in patients switched to simvastatin in a community-based family medicine practice

Abstract

These results demonstrate that an independent family medicine physician practice can successfully perform statin therapeutic substitution during routine patient care. Equivalent clinical outcomes with regards to changes in lipid fractions and NCEP LDL-C goal attainment were observed in conjunction with the potential for reduced costs for patients.

Switching from high-efficacy lipid-lowering therapies to simvastatin and low-density lipoprotein cholesterol goal attainment in coronary heart disease/coronary heart disease-equivalent patients

“…Nonetheless, these results are consistent with previous findings after highefficacy statin switches to equivalent or lower efficacy doses of simvastatin. [20][21][22]29,30 Overall, this study illustrates how increased generic use without careful consideration of patient risk factors and current therapy can lead to switches to less efficacious dosages, higher LDL-C levels, and lower goal attainment rates. This information may help to inform physicians when considering therapeutic options.…”

Non-adherence to lipid-lowering therapies: a need for more studies to evaluate reasons for medication non-adherence

“…However, the reasons for poor adherence are not well understood. In a recent study (4), in patients with coronary heart disease, a 26% rate of non-compliance to statins was found, which was in turn associated with an 85% increase in overall mortality. Although the causes for non-compliance are multifactorial, the lack of education and awareness about long-term benefits of treatment may be one of the major reasons.…”

“…In clinical practice, physicians play an important role to reduce the impact brought forth by dyslipidaemia. Family physicians are influential on its control -this has been impressively demonstrated by a recent study in a US, community-based, independent family medicine practice, where statin therapeutic substitution could be successfully performed within the context of its typical patient care (4). In addition, there is a modelled annual cost savings associated with medication switching.…”

Clinical Implications of Switching Lipid Lowering Treatment from Rosuvastatin to Other Agents in Primary Care

“…Recently, the introduction of generic statins has enabled highly cost-effective LDL-C reduction in clinical practice and third party payers often recommend substitution of branded agents with generic alternatives [6]. However, even if switching from brand-name drugs to generic equivalents may reduce prescription costs, it may also potentially compromise therapeutic benefits if generic options are not of equivalent efficacy [7].…”