Comparison of Prescription Drug Costs in the United States and the United Kingdom, Part 1: Statins

Hershel Jick, M.D.; Andrew Wilson, M.P.H.; Peter Wiggins, M.B.; Douglas P. Chamberlin, B.A.

Disclosures

Pharmacotherapy. 2012;32(1):1-6. 

In This Article

Results

Of an estimated 280,000 people aged 55–64 years in each country, 91,474 (32.7%) in the U.S. and 68,217 (24.4%) in the U.K. received at least one prescription for a statin in 2005. Based on two separate independent random samples of 100 statin recipients, we estimated that 70% received prescriptions continuously for the entire year (annual statin user) in each country in 2005. Among the annual statin users, 4% in the U.S. and 5% in the U.K. were recorded as switching from one statin to another during the year. After excluding those who switched drugs, the study population consisted of 61,470 annual statin users in the U.S. and 45,788 annual users in the U.K. The final cost estimates were derived from two additional independent random samples of 100 people in each country from this study population.

Table 1 shows the estimated distribution of annual statin use in the two countries. Six statins were prescribed in the U.S.; of the study popoulation, an estimated 59% were prescribed atorvastatin, 18% simvastatin, 11% pravastatin, 5% lovastatin, 5% rovastatin, and 3% fluvastatin. Only lovastatin was available as a generic formulation in 2005. In the U.K., five statins were prescribed. An estimated 46% of annual users were prescribed simvastatin and 44% atorvastatin. Rosuvastatin (7%), pravastatin (2%), and fluvastatin (1%) were prescribed infrequently. Only simvastatin and pravastatin were available as generic formulations in 2005. Lovastatin was not available in the U.K. in 2005.

The average estimated annual cost/patient for each drug by country in 2005 together with the total annual cost is shown in Table 2. In the U.S., the most costly drug was simvastatin, followed by pravastatin, atorvastatin, rosuvastatin, fluvastatin, and then lovastatin. The cumulative cost in the U.S. for statins prescribed annually in the population of 280,000 people aged 55–64 years in 2005 was estimated to be $64,950,000 (Table 2). The estimated average cost/pill varied from a high of $3.91 for simvastatin to a low of $0.93 for lovastatin (Table 3).

Statins were prescribed on a monthly (30 days) basis in about 30% of recipients. The remainder was prescribed the drugs every 3 months (90 days). The annual cost for statins prescribed monthly was estimated to be about 10% higher than that for every 3 months. Costs for higher dose pills were also regularly more than 10% higher than the costs for lower doses.

In the U.K., the most costly statin was atorvastatin, followed by rosuvastatin, pravastatin, fluvastatin, and then simvastatin (Table 2). The cumulative cost for statins prescribed annually in the U.K. was estimated in U.S. dollars to be $15.7 million in some 280,000 people aged 55–64 years in 2005 (Table 2). The average cost/pill ranged from $1.40 for atorvastatin to $0.45 for simvastatin (Table 3).

Statins were prescribed on a monthly (28 days) basis for an estimated 38% of recipients. The remainder was prescribed the drugs every 2 months (56 days) in 53% and every 3 months (84 days) in 9%. Lower dose pills cost about 20% less than higher dose pills. Costs according to duration of the prescription were not available separately in the U.K.

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