In the United States, the cost paid for statins in those
aged younger than 65 years who have private insurance is approximately 400%
higher than comparable costs paid by the government in the United Kingdom.
These findings, from the Boston University School of
Medicine Boston Collaborative Drug Surveillance Program, are the first results
of a comprehensive comparison of prescription drug costs between the United
States and United Kingdom.
For this study, researchers analyzed two large
electronic medical databases in the United States and United Kingdom. Costs
were derived from private health insurance claims in the United States, while
costs were originated from a general practice research database in the United
Kingdom, according to information in a press release.
The results are based on a 2005 sample of 280,000 people
aged 55 to 65 years living in the United States and the United Kingdom. Statins
were prescribed to approximately 33% of people in the United States and 24% in
the United Kingdom. In the United States, the estimated annual cost of statins
ranged from $1,428 for simvastatin (generic unavailable at the time) to $313
for lovastatin (generic available). In the United Kingdom, the estimated annual
cost varied from $509 for atorvastatin (generic unavailable at the time) to
$164 for simvastatin (generic available). The estimated cost per pill was at
least twice as high for each statin prescribed in both countries.
When the researchers combined the annual cost for each
statin user with the number of users, the total estimated cost for statin users
was $64.9 million for people covered by private insurance companies in the
United States vs. $15.7 million for people covered by the government in the
In addition to differences in overall statin use
and per unit costs, another significant factor contributing to the disparity of
costs appears to be the availability and utilization of generics,
Hershel Jick, MD, director emeritus of Boston University School of
Medicines Collaborative Drug Surveillance Program, said in a press
Analyzing the 2005 sample, six statins were prescribed
to the study population in the United States: atorvastatin (59%; Lipitor,
Pfizer; now available as generic); simvastatin (18%; Zocor, Merck); pravastatin
(11%; Pravachol, Teva Pharmaceuticals); lovastatin (5%); rovastatin (5%;
Crestor, AstraZeneca); and fluvastatin (3%; Lescol, Novartis). Five statins
were prescribed in the United Kingdom: simvastatin (46%); atorvastatin (44%);
rosuvastatin (7%); pravastatin (2%); and fluvastatin (1%).
Only generic lovastatin, which was used by just 5%
of statin users, was available in the United States in 2005. In contrast, two
drugs, simvastatin and pravastatin, prescribed to 48% of statin users, were
available as generics in the United Kingdom, the researchers wrote.
Simvastatin was approved in the United States for sale
as a generic in June 2006, according to information in the article. Within the
following 6 months, more than 60% of users switched from the brand-name statin
to the generic formulation, leading to an estimated cost reduction of more than
50%, results showed.
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Disclosure: The researchers report no relevant