The University of Southampton
University of Southampton Institutional Repository

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
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
0141-0768
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
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).

Record type: Article

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
Available under License Creative Commons Attribution.
Download (605kB)

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
ORCID for Emmanouil Mentzakis: ORCID iD orcid.org/0000-0003-1761-209X
ORCID for Simon D.S. Fraser: ORCID iD orcid.org/0000-0002-4172-4406
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: 06 Jan 2022 18:00
Last modified: 06 Jun 2024 01:50

Export record

Altmetrics

Contributors

Author: Matias Ortiz De Zarate
Author: Paul Roderick ORCID iD
Author: Paul Rutter
Author: Carmine Ornaghi ORCID iD

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×