Of the eight cholesterol lowering statins approved by the FDA, two have remained patented until recently – rosuvastatin (Crestor) and pitavastatin (Livalo). Despite similar performance of decreasing LDL cholesterol, as compared to other statins, the price of Crestor increased 91% during 2007-2012, from $112 to $214 per prescription. During the same time, the price of comparably effective atorvastatin decreased from $127 to $26 per prescription due to the expiration of its patent in 2011. 1,2
Consider prescription cost: Studies have shown that patients who were prescribed a costly branded product rather than a more affordable generic alternative were less adherent to their regimen than those who received a similar generic drug, and ultimately had worse health outcomes. 3,4
Patients can spend an average of $2,500 annually for a brand statin, compared to about $250 for a generic. Choosing to prescribe a generic statin decreases out of pocket costs, helps prevent reaching the Part D coverage gap (donut hole) for Medicare patients, and may increase medication adherence which decreases the risk of hospitalization for an acute coronary syndrome or stroke.
The next time you prescribe a statin, consider generic options.
1. Saku K, Zhang B, Noda K; PATROL Trial Investigators. Randomized head-to-head comparison of pitavastatin, atorvastatin, and rosuvastatin for safety and efficacy (quantity and quality of LDL): the PATROL trial. Circ J. 2011;75(6):1493-1505. 2. Consumer Reports. Knowing when prescription prices are high and how to avoid overspending.http://www.consumerreports.org/cro/2012/11/where-high-drug-costs-hide/index.htm. Published November 2012. Assessed August 30, 2016. 3. Shrank, WH, Hoang T, Ettner SL, et al. The implications of choice: prescribing generic or preferred pharmaceuticals improve medication adherence for chronic conditions. Arch Intern Med. 2006;166(3):332-337. 4. Gagne JJ, Choudhry NK, Kesselheim AS, et al. Comparative effectiveness of generic and brand-name statins on patient outcomes: a cohort study. Ann Intern Med. 2014;161(6):400-407.