Study: Statin costs 400% higher in U.S. than in U.K.

Privately insured statin users between 55 and 64 years old in the U.S. paid 400 percent higher costs for the drug than did their counterparts in the U.K. whose drugs were paid through the government, according to a study published in the January issue of the journal Pharmacotherapy. The authors found generics cost substantially less in both countries.

Deriving reliable and comparable cost estimates of physician drug prescribing across nations is challenging, lead author Hershel Jick, MD, director emeritus of the Boston Collaborative Drug Surveillance Program at Boston School of Medicine, and colleagues acknowledged. For this matched-cohort cost analysis, they built off a previous study in which they compared the frequency of prescribing drugs in the U.S. and U.K.

That earlier research allowed them to become adept using two electronic longitudinal databases that were critical in the design of the statin study. The databases included the General Practice Research Database (GPRD) in the U.K. and the MarketScan Commercial Claims and Encounters Database in the U.S. The GPRD captures all prescriptions recorded in patient records while MarketScan covers claims of insured patients, including drugs dispensed and payment information.

For their study, Jick and colleagues identified 1.6 million people in each database who were younger than 65 years old in 2005. From that pool they whittled the total to 91,474 people in U.S. and 68,217 people in the U.K. who were between 55 and 64 years old and had been prescribed a drug in 2005. From that group they then identified 61,470 patients in the U.S. and 45,788 patients in the U.K. who were prescribed a statin and remained on that drug throughout the year. That group’s data were used for the cost analysis. Cost estimates were calculated in 2005 U.S. dollars.

They estimated that the cumulative cost for statin use in the U.S. in 2005 was nearly $65 million. The average cost per pill was highest for simvastatin (Zocor, Merck) at $3.91 a pill and lowest for lovastatin at 93 cents a pill.

In the U.K., annual cumulative costs totaled $15.7 million and the average cost per pill ranged from $1.40 for atorvastatin (Lipitor, Pfizer) to 45 cents for simvastatin.

“Overall, physicians prescribed statins for an estimated 40 percent more people in the U.S. compared with the U.K.,” the authors wrote. “In the U.S. population of continuous users, the cost ($64.9 million) was estimated to be more than 400 percent higher than the cost in comparable statin users in the U.K. ($15.7 million).”

They additionally pointed out that higher statin use in the U.S. may lead to an increase in health benefits.

Annual costs per patient in the U.S. ranged from $313 for lovastatin, a generic, to $1,428 for simvastatin. In the U.K., the generic simvastatin cost $164 per patient while the nongeneric atorvastatin was $509 per patient.

They attributed the cost disparity to the availability and use of generics. In an addendum, they noted that simvastatin had been approved in the U.S. as a generic in June 2006. They decided to analyze 2006 data to study cost trends and found simvastatin costs for the first six months of 2006 were similar to their 2005 findings but in the second half of that year, 60 percent of users switched to the generic.

“The resultant estimated cost/pill was reduced by more than 50 percent,” they observed. “It was nevertheless still some four times higher than in the U.K.”