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

Expert Rev Pharmacoecon Outcomes Res. 2015 Apr;15(2):323-30. doi: 10.1586/14737167.2015.967221. Epub 2014 Oct 23.

Abstract

Introduction: 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.

Keywords: PDDs; South Africa; demand-side measures; dosing; drug utilisation; generics; prices; statins.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atorvastatin / administration & dosage
  • Atorvastatin / economics
  • Atorvastatin / therapeutic use
  • Dose-Response Relationship, Drug
  • Drug Costs
  • Drugs, Generic / administration & dosage
  • Drugs, Generic / economics
  • Drugs, Generic / therapeutic use*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / economics
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hyperlipidemias / drug therapy*
  • Practice Patterns, Physicians' / standards*
  • Practice Patterns, Physicians' / trends
  • Rosuvastatin Calcium / administration & dosage
  • Rosuvastatin Calcium / economics
  • Rosuvastatin Calcium / therapeutic use
  • Simvastatin / administration & dosage
  • Simvastatin / economics
  • Simvastatin / therapeutic use
  • South Africa

Substances

  • Drugs, Generic
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Rosuvastatin Calcium
  • Atorvastatin
  • Simvastatin