In the United States, the cost paid for statins (drugs to lower cholesterol) in people under the age of 65 who have private insurance is approximately 400 percent higher than comparable costs paid by the government in the United Kingdom (U.K.). These findings, from the Boston University School of Medicine (BUSM) Boston Collaborative Drug Surveillance Program, are the first results of a comprehensive comparison of prescription drug costs between the U.S. and U.K. The study appears on-line in the journal Pharmacotherapy.
Expenditures for prescription drugs remain a large part of the ongoing debate on the costs of medical care in the U.S. and U.K. Because of the many complex and interactive variables that contribute to these costs, well-defined estimates of the actual and relative usage and costs for the two countries have not been reliably documented.
Data for this study came from two large electronic medical databases, one in each country. Costs were derived from private health insurance claims in the U.S., while the costs were originated from a general practice research database constructed in 1990 in the U.K.
The study is based upon a 2005 sample of 280,000 people age 55-64 in each country. Statins were prescribed to an estimated 32.7 percent of people in the U.S. and 24.4 percent in the U.K. In the U.S. the estimated annual cost of statins ranged from a high of $1,428 for simvastatin (generic unavailable), to a low of $314 for lovastatin (available in generic formulation). In the U.K. the annual cost varied from a high of $500 for atorvastatin (generic not available), to a low of $164 for simvastatin (available in generic). The estimated cost per pill was at least twice as high for each statin prescribed in both countries.
When the annual cost for each annual statin user together with the number of users were combined, the total estimated cost for statin users was $69.5 million in people covered by private insurance companies in the U.S. The total estimated annual cost for statin users covered by the government in the U.K. was $15.7 million.
“In addition to differences in overall statin use and per unit costs, another significant factor contributing to the disparity of costs appears to be the availability and utilization of generics,” said lead author Hershel Jick, MD, Director Emeritus of BUSM’s Collaborative Drug Surveillance Program and associate professor of medicine at BUSM.
According to the researchers, simvastin was approved in the U.S. for sale in generic formulation in late June 2006. Accordingly, within the next six months more than 60 percent of users switched from the brand preparation to the generic. The resultant estimated cost was reduced more than 60 percent. According to the researchers, however, it still was four times higher than that in the U.K.
BUSM’s Boston Collaborative Drug Surveillance Program was established in 1966. It was the first group to conduct formal epidemiologic research to quantify the potential adverse effects of prescription drugs utilizing in-hospital monitoring and had a pioneering role in the development and application of methods in drug epidemiology.