Impact of Restricted Reimbursement on the Use of Statins in Finland

Abstract

Restricted reimbursement of expensive statins decreased their use. It seems that after the policy new statin treatments have channeled appropriately. Although it is likely that the cost-containment aim of the policy was reached, health and long-term effects are not known.

Dynamics of long-term statin therapy

“…These two statins remained reimbursable only for treatment of severe disorders of lipid metabolism in high risk patients who were not able to use less expensive statins due to intolerance or ineffectiveness [23]. In practice, users of atorvastatin and rosuvastatin were entitled to reimbursement only after they had tried less expensive statins first.…”

European payer initiatives to reduce prescribing costs through use of generics

“…This is because their nature and follow-up appear to influence subsequent utilisation patterns appreciably [4,15,17,26]. For instance, the prescribing restrictions for patent-protected statins, atorvastatin and rosuvastatin, had less influence on increasing the utilisation of generic statins, e.g.…”

“…simvastatin, in Norway versus Austria and Finland. This was the result of having no prior authorisation scheme in Norway, unlike Austria, or no close scrutiny over prescriptions as seen in Finland [4,15,17]. In Austria, atorvastatin and rosuvastatin can only be reimbursed if physicians obtain agreement from the Chief Medical Officer of the patient's Social Health Insurance Fund [4].…”

“…However, the variety of measures can be categorised into three distinct approaches [1,3,4,8,11,[14][15][16][17]:…”

Differences in utilization rates between commercial and administrative databases: implications for future health-economic and cross-national studies

“…Patented statins were restricted to second line in Norway and Finland, limiting their utilization in Finland to just 18.3% of total statin utilization, ARBs were restricted to second line after angiotensin converting enzyme inhibitors (ACEIs) in a number of European countries limiting their utilization, and more recently patented ARBs were restricted to second line versus generic ARBs in Austria and Belgium following generic availability again significantly reducing their use [10][11][12][13][14].…”