Price versus clinical guidelines in primary care statin prescribing: a retrospective cohort study and cost simulation model
Price versus 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 National Institute for Health and Care Excellence 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 statin’ 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. Significant heterogeneity is observed 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, ongoing 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.
clinical guidelines, patent expiration, prescribing behaviour, statins
De Zarate, Matias Ortiz
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Mentzakis, Emmanouil
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Fraser, Simon D.S.
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Roderick, Paul
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Rutter, Paul
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Ornaghi, Carmine
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18 November 2021
De Zarate, Matias Ortiz
a16bfe38-2fc4-4093-a9d9-bce0ba29f04d
Mentzakis, Emmanouil
c0922185-18c7-49c2-a659-8ee6d89b5d74
Fraser, Simon D.S.
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Rutter, Paul
162ac51a-8770-4b6f-a95f-d8dd5effe706
Ornaghi, Carmine
33275e47-4642-4023-a195-39c91d0146b0
De Zarate, Matias Ortiz, Mentzakis, Emmanouil, Fraser, Simon D.S., Roderick, Paul, Rutter, Paul and Ornaghi, Carmine
(2021)
Price versus clinical guidelines in primary care statin prescribing: a retrospective cohort study and cost simulation model.
Journal of the Royal Society of Medicine.
(doi:10.1177/01410768211051713).
Abstract
Objective: To investigate the relative impact of generic entry and National Institute for Health and Care Excellence 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 statin’ 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. Significant heterogeneity is observed 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, ongoing 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.
Text
01410768211051713
- Version of Record
More information
Accepted/In Press date: 21 September 2021
e-pub ahead of print date: 18 November 2021
Published date: 18 November 2021
Additional Information:
Publisher Copyright:
© 2021, The Royal Society of Medicine.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
clinical guidelines, patent expiration, prescribing behaviour, statins
Identifiers
Local EPrints ID: 452942
URI: http://eprints.soton.ac.uk/id/eprint/452942
ISSN: 0141-0768
PURE UUID: db942155-95af-4262-943e-d8d69cfe394b
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Date deposited: 06 Jan 2022 18:00
Last modified: 06 Jun 2024 01:50
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Author:
Matias Ortiz De Zarate
Author:
Paul Rutter
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