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Price vs. clinical guidelines in primary care statin prescribing: a retrospective cohort study and cost simulation model

Price vs. clinical guidelines in primary care statin prescribing: a retrospective cohort study and cost simulation model
Price vs. clinical guidelines in primary care statin prescribing: a retrospective cohort study and cost simulation model
Objective: To investigate the relative impact of generic entry and NICE clinical guidelines on prescribing using statins as an exemplar.
Design: Retrospective analysis of statin prescribing in primary care, and cost simulation model.Setting: Royal College of General Practitioners Research and Surveillance Centre (RCGP R&SC) database and Prescription Cost Analysis (PCA) database.
Participants: New patients prescribed statins for the first time between July 2003 and September 2018. 
Results: General trends of statins' prescriptions were largely driven by a decrease in acquisition costs triggered by patent expiration, preceding NICE guidelines which themselves did not seem to affect prescription trends. We also observe significant heterogeneity in the prescription of the most cost-effective statin across GPs. A cost simulation shows that, between 2004 and 2018, the NHS could have saved £2.8bn (around 40% of the £6.3bn spent on statins during this time) if all GP practices had prescribed only the most cost-effective treatment.
Conclusions: There is potential for large savings for the NHS if new and, whenever possible, on-going patients are promptly switched to the first medicine that becomes available as generic within a therapeutic class as long as it has similar efficacy to still patented medicines.
statins, NICE guidelines, generics
0141-0768
Ortiz De Zarate Rodriguez, Matias, Francisco
322eb435-7e30-4daf-96e8-829ae249a2e9
Mentzakis, Emmanouil
c0922185-18c7-49c2-a659-8ee6d89b5d74
Fraser, Simon
cda9a739-eedc-47e5-9dd7-17dda85349ee
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Rutter, Paul
659c83cd-3283-4328-8bee-fe3084a49c16
Ornaghi, Carmine
33275e47-4642-4023-a195-39c91d0146b0
Ortiz De Zarate Rodriguez, Matias, Francisco
322eb435-7e30-4daf-96e8-829ae249a2e9
Mentzakis, Emmanouil
c0922185-18c7-49c2-a659-8ee6d89b5d74
Fraser, Simon
cda9a739-eedc-47e5-9dd7-17dda85349ee
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Rutter, Paul
659c83cd-3283-4328-8bee-fe3084a49c16
Ornaghi, Carmine
33275e47-4642-4023-a195-39c91d0146b0

Ortiz De Zarate Rodriguez, Matias, Francisco, Mentzakis, Emmanouil, Fraser, Simon, Roderick, Paul, Rutter, Paul and Ornaghi, Carmine (2021) Price vs. clinical guidelines in primary care statin prescribing: a retrospective cohort study and cost simulation model. Journal of the Royal Society of Medicine. (In Press)

Record type: Article

Abstract

Objective: To investigate the relative impact of generic entry and NICE clinical guidelines on prescribing using statins as an exemplar.
Design: Retrospective analysis of statin prescribing in primary care, and cost simulation model.Setting: Royal College of General Practitioners Research and Surveillance Centre (RCGP R&SC) database and Prescription Cost Analysis (PCA) database.
Participants: New patients prescribed statins for the first time between July 2003 and September 2018. 
Results: General trends of statins' prescriptions were largely driven by a decrease in acquisition costs triggered by patent expiration, preceding NICE guidelines which themselves did not seem to affect prescription trends. We also observe significant heterogeneity in the prescription of the most cost-effective statin across GPs. A cost simulation shows that, between 2004 and 2018, the NHS could have saved £2.8bn (around 40% of the £6.3bn spent on statins during this time) if all GP practices had prescribed only the most cost-effective treatment.
Conclusions: There is potential for large savings for the NHS if new and, whenever possible, on-going patients are promptly switched to the first medicine that becomes available as generic within a therapeutic class as long as it has similar efficacy to still patented medicines.

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Statin_JRMS - Accepted Manuscript
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Accepted/In Press date: 21 September 2021
Keywords: statins, NICE guidelines, generics

Identifiers

Local EPrints ID: 451663
URI: http://eprints.soton.ac.uk/id/eprint/451663
ISSN: 0141-0768
PURE UUID: 82d7d365-0eb3-42ff-9444-e638cb04d3d3
ORCID for Emmanouil Mentzakis: ORCID iD orcid.org/0000-0003-1761-209X
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Carmine Ornaghi: ORCID iD orcid.org/0000-0003-2704-2537

Catalogue record

Date deposited: 19 Oct 2021 16:30
Last modified: 13 Dec 2021 03:08

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Contributors

Author: Matias, Francisco Ortiz De Zarate Rodriguez
Author: Simon Fraser
Author: Paul Roderick ORCID iD
Author: Paul Rutter
Author: Carmine Ornaghi ORCID iD

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