For the millions of Americans taking statin medications to lower their cholesterol, which work better, generic or brand-name drugs?
According to a new study by Brigham and Women's Hospital, Harvard Medical School, and CVS Health, those taking generic statins, such as atorvastatin (Lipitor) or simvastatin (Zocor), had better health outcomes than those who took brand-name statins. The study was published in the Annals of Internal Medicine.
Statin drugs are commonly prescribed to prevent cardiac events, such as a heart attack, and work to block a liver enzyme that produces cholesterol. But people who are prescribed statins do not always take them as directed, and so do not get all the benefits of the drugs.
Using data from the medical claims of patients 65 and older who had prescription drug coverage between 2006 and 2008, the researchers calculated how well patients stuck to their medication schedule and whether or not they experienced acute coronary syndrome, stroke, or death.
Those taking generic statins were more likely than patients on brand-name statins to stick to the treatment. Those patients also had 8 percent lower rates of death and cardiovascular events, such as heart attacks and strokes.
It all boils down to an issue of cost.
Joshua J. Gagne, Pharm.D., lead study author and an assistant professor of medicine at the Brigham and Women's Hospital's division of pharmacoepidemiology and pharmacoeconomics, said that generic drug use usually lowers a patient’s out-of-pocket costs. Patients in the study had an average copayment of $10 for a generic statin and a whopping $48 for a brand-name statin.
"Our study is the first to investigate whether generic versus brand-name statins play a direct role in improving health outcomes," Gagne said. "Patients will only get the full clinical benefit of their medications if they take them, and our study found that patients are more likely to take generic statins than brand-name versions, which have a higher associated cost."
"Generic drug use has been widely recognized to reduce patient out-of-pocket costs and payer spending. Our finding that adherence is greater with generic statins is consistent with other studies that have shown a direct relation between higher co-payments and lower adherence,” he added.
Experts believe that doctors and patients should consider trying generic statins.
“This contribution adds greatly to our understanding of how medication cost affects adherence, and is particularly significant because the authors were able to show a link to real clinical outcomes that are meaningful to patients,” said Dr. Jason Wasfy, a cardiologist at Massachusetts General Hospital in Boston.
“For doctors, this underscores the importance of considering generic medications,” he added. “The results of clinical trials with expensive drugs are not meaningful or relevant if patients cannot afford the expensive drugs.”
The American Heart Association and the American College of Cardiology released new guidelines for statin use in November 2013. The new rules mean that 56 million Americans ages 40 to 75 may now qualify to take statins, according to a study published in April. About 25 million Americans are currently taking statin drugs.