Older Patients More Likely to Fill Prescriptions for Generic Statins: Study

Higher use of cheaper types of cholesterol-lowering drugs led to a lower risk of heart problems

Monday, September 15, 2014

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MONDAY, Sept. 15, 2014 (HealthDay News) -- Patients prescribed cholesterol-lowering drugs are more likely to fill their prescriptions and gain health benefits if the medications are cheaper generic brands, new research suggests.

At issue are the cholesterol-lowering drugs known as statins. Well-known brands include Crestor, Zocor and Lipitor. Generic statins are also available. The drugs are designed to lower the risk of heart problems due to clogged arteries.

About half of patients on statins stop taking them within the first year, explained study lead author Joshua Gagne, an assistant professor of medicine with Brigham and Women's Hospital and Harvard Medical School in Boston.

Statins are among the most "notorious" medications in terms of low adherence -- patients actually taking them when they're prescribed, said Dr. Orli Etingin, a professor of clinical medicine at Weill Cornell Medical College-New York Presbyterian Hospital and a specialist in blood vessel disorders.

"A lot of patients don't believe they need those statins, and it can be hard to convince patients that they really do," she said. Bad publicity about the potential side effects doesn't help matters since it distracts attention from the beneficial effects of the medications, she said.

The new study was funded by Teva Pharmaceuticals, a top manufacturer of generic drugs. The drug company didn't design or manage the study. The research appeared online Sept. 15 in the Annals of Internal Medicine.

In the new study, researchers examined the prescription records of more than 90,000 people aged 65 and over who were on Medicare. All were prescribed statins between 2006 and 2008 -- the most recent time period for which numbers are available.

The study looked at brand-name drugs and those that had generic equivalents. Ninety-three percent of people were started on a generic drug. Just 7 percent started with a brand-name drug, according to the study.

Researchers didn't know how often patients actually took the drugs, but they were able to analyze how often they got the prescriptions filled. Those who used the generic drugs got doses for 77 percent of the days for a period of use up to a year. That number was 71 percent for those in the brand-name group.

Those who took the generic drugs appeared to be poorer on average, based on where they lived. They were also less likely to die or suffer from heart problems while on the drugs compared to those who took the brand-name medications. However, the study wasn't able to prove that taking generic statins caused fewer heart issues, only that there was an association between those factors.

Price may be a factor in whether or not people got the prescriptions filled. The study found that the copay for generic statins was $10 on average, compared to $48 for the brand-name drugs.

Etingin said there's rarely a reason for a doctor to prescribe a brand-name statin instead of a generic. One exception, she said, are certain patients who may do better on the brand drug Crestor because they have higher blood levels of a substance called C-reactive protein. C-reactive protein has been linked to higher levels of inflammation in blood vessels.

In the big picture, lead author Gagne said, "there are reasons to think that our results might apply to other drugs because, as with statins, other drugs only work if patients take them, but our study focused specifically on statins."

SOURCES: Joshua Gagne, Pharm.D., Sc.D., assistant professor, medicine, division of pharmacoepidemiology and pharmacoeconomics, department of medicine, Brigham and Women's Hospital and Harvard Medical School, Boston; Orli Etingin, M.D., professor, clinical medicine, Weill Cornell Medical College-New York Presbyterian Hospital, New York City; Sept. 16, 2014, Annals of Internal Medicine

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