What's more effective: Generic or brand-name statins?

Statins are the most frequently prescribed drugs in the United States and are effective in reducing cardiovascular events. However, evidence suggests that patients do not always take these medications as prescribed and may not receive their full benefit. Researchers from Brigham and Women's Hospital (BWH), Harvard Medical School and CVS Health investigated whether the use of generic versus brand-name statins can play a role in medication adherence and whether or not this leads to improved health outcomes. They found that patients taking generic statins were more likely to adhere to their medication and also had a significantly lower rate of cardiovascular events and death. These findings are published in the Annals of Internal Medicine on September 15, 2014.

"Our study is the first to investigate whether generic versus brand-name statins play a direct role in improving health outcomes," explained Joshua J. Gagne, PharmD, ScD, assistant professor of medicine in BWH's Division of Pharmacoepidemiology and Pharmacoeconomics and lead author of this study. "Patients will only get the full clinical benefit of their medications if they take them, and our study found that patients are more likely to take generic statins than brand-name versions, which have a higher associated cost."

The researchers used electronic data from medical and pharmacy claims and looked at Medicare beneficiaries aged 65 years or older with prescription drug coverage between 2006 and 2008. They measured adherence to statin therapy and outcomes comprising of hospitalization for an acute coronary syndrome, stroke and mortality. In this head-to-head comparison, they found that patients initiating generic statins were more likely than those initiating brand-name statins to adhere to their prescribed treatment and had an eight percent lower rate of cardiovascular events and death.

"Generic drug use has been widely recognized to reduce patient out-of-pocket costs and payer spending. Among patients in our study, the mean copayment for the generic statin was $10 and $48 for brand-name statins," explained Gagne. "Our finding that adherence is greater with generic statins is consistent with other studies that have shown a direct relation between higher copayments and lower adherence."

The researchers conclude that in the setting of tiered copayments in typical pharmacy benefit designs, initiating generic versus name-brand statins seems to be associated with lower out-of-pocket costs, improved adherence to therapy and improved clinical outcomes.

This research was supported by Teva Pharmaceuticals (2010A057139).

Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 3.5 million annual patient visits, is the largest birthing center in New England and employs nearly 15,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Biomedical Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 1,000 physician-investigators and renowned biomedical scientists and faculty supported by nearly $650 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH continually pushes the boundaries of medicine, including building on its legacy in transplantation by performing a partial face transplant in 2009 and the nation's first full face transplant in 2011. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative.

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