Save on Medication: Older Patients Are More Likely to Use Generics

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Doctors prescribe statin drugs including Lipitor (Atorvastatin) to reduce the risk of heart problems due to clogged arteries. However, patient compliance for these cholesterol-lowering drugs is low, according to Dr. Orli Etingin, a specialist in blood vessel disorders and professor of clinical medicine at Weill Cornell Medical College-New York Presbyterian Hospital. A new study discovered a possible reason that deters seniors from filling these prescriptions.

Price May Be a Determining Factor

A study from the Annals of Internal Medicine examined prescription records of over 90,000 people aged 65 and up on Medicare. All study subjects received

statin prescriptions

between 2006 and 2008, the most recent period with available statistics. Ninety-three percent of patients started on generic medications. Just 7 percent began taking brand-name drugs.

The study analyzed how often patients filled their prescriptions. Those who used generic drugs got doses for 77 percent of the days for a period of use up to a year. That number was 71 percent for those in the brand-name group. About half of patients on statins stopped taking them within the first year, according to study lead author Joshua Gagne, Pharm.D., Sc.D., an assistant professor of medicine with Brigham and Women’s Hospital and Harvard Medical School in Boston, Mass.

Because patients who took statins were more likely to buy generic prescriptions, the investigators concluded that price might be a factor in whether or not people filled their prescriptions. For this group of seniors, generics cost about 20 percent less than name-brand medications. People who took generic drugs appeared to be poorer on average, based on where they lived. In addition, they were less likely to die or suffer from heart problems while taking generics, compared to those who bought brand-name medications.

Etingin said doctors rarely have reasons to prescribe brand-name statins instead of generics. In the big picture, Gagne noted that his results might apply to other drugs as well because medications provide health benefits only if patients take them.

Atorvastatin Advantages

Like all statins, Atorvastatin prevents your liver from producing cholesterol by blocking the HMG-CoA reductase enzyme and reduces the amount of cholesterol your intestines absorb. This decreases total cholesterol, low-density lipoprotein (LDL) or bad cholesterol, and triglycerides while increasing high-density lipoprotein (HDL) or good cholesterol circulating in your blood. These actions protect against coronary artery disease, retard its progression, or even reverse it.

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Study Confirms Lipitor Benefits

Lipitor is Medication used for treatment of Cholesterol

Lipitor (Atorvastatin) achieved an unprecedented reversal of atherosclerosis, according to a


that the New England Journal of Medicine published. Researchers in Ohio found that maximum doses decreased the buildup of cholesterol plaques in patients’ coronary artery walls by 0.99 percent after two years. The researchers associated virtually no adverse side effects with treatment. They reported that their findings confirm the benefits of taking statin medications.

According to lead researcher Stephen Nicholls, M.D., Ph.D., cardiovascular director of the Cleveland Clinic Coordinating Center for Clinical Research (C5), this study demonstrates that the highest doses of the most effective statins available currently are safe, patients tolerate them well, and they produce significant plaque regression. The findings that statins produce low LDL levels, raise HDL, and remove plaque from artery walls in a safe manner is positive news for heart disease patients.

Statins’ History of Success

For decades, studies have documented the benefits of statins for secondary prevention, averting another heart attack or stroke after having one. Michael Brown and Joseph Goldstein won the 1985 Nobel Prize in Medicine for their statin research. The 1994 Scandinavian Simvastatin Survival Study, still the definitive

statin study

, found that treating patients with pre-existing

heart disease

decreased their chance of dying over five years from 12 percent without statins to eight percent with the drugs. Their risk of cardiac death, heart attack, or need for heart surgery dropped from about 30 percent without statins to about 20 percent with treatment over five years.

“If you’re in this category, you would definitely want to take a drug that decreased your chance of dying or having a major cardiac event by a third,” said Dr. Eli Farhi, an assistant professor of cardiology at the University at Buffalo School of Medicine and Biomedical Sciences in New York.

Statins cut America’s death rate from coronary heart disease in half, one of the greatest public health triumphs of the past 30 years. Data from the U.S. Centers for Disease Control and Prevention showed that the death rate fell from 543 per 100,000 men in 1980 to 267 per 100,000 (adjusted for the aging of the population) in 2000. Deaths per 100,000 women declined from 263 in 1980 to 134 per 100,000 in 2000. Due to the lower death rate from coronary heart disease, 341,745 fewer Americans died in 2000 alone.

Many cardiovascular experts prescribe life-saving statins as primary prevention. Dr. Marc Gillinov, co-author of the Heart 411 book, said, “If someone has high LDL as well as high blood pressure or a history of smoking or other risk factors such as age and gender, let’s take that one risk factor [elevated cholesterol] out of the equation.”