Potential savings without compromising the quality of care

Norman, Christer; Zarrinkoub, Ramin; Hasselström, Jan; Godman, Brian; Granath, Fredrik; Wettermark, Björn

doi:10.1111/j.1742-1241.2009.02129.x

Cited by 49 publications

(49 citation statements)

References 40 publications

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“…generic simvastatin [5-8, 11, 14, 15, 17, 19, 25]. These beliefs are endorsed by a recent ecological study, which showed that outcomes, in terms of the subsequent impact of drug treatment on lipid levels, were similar whether patients were prescribed formulary drugs (including generic simvastatin) versus non-formulary drugs, which included patent-protected statins [32]. Published studies have also shown that patients can be successfully switched from atorvastatin to simvastatin without compromising care [33], and physicians in UK extensively prescribe generic simvastatin to achieve agreed target lipid levels in the quality and outcomes framework to help maximise their income [14,21,34,35].…”

Section: Review Articlementioning

confidence: 53%

“…Alongside this, pharmaceutical companies have failed to provide reimbursement agencies with any published studies documenting increased effectiveness of ARBs versus ACEIs to support premium prices for ARBs [26,27]. In addition, only 2-3% of patients in the ACEI clinical trials actually discontinued ACEIs due to coughing [36,37], and a recent ecological study again showed that outcomes, in terms of the subsequent impact of drug treatment on blood pressure, were similar whether patients were prescribed formulary drugs (including generic ACEIs) versus non-formulary drugs, which included patent-protected ARBs [32]. As a result, generic ACEIs can be prescribed first line with patent-protected ARBs reserved for patients where there are concerns with side effects without compromising outcomes.…”

Section: Review Articlementioning

confidence: 99%

See 1 more Smart Citation

European payer initiatives to reduce prescribing costs through use of generics

Godman¹,

Wettermark²,

Bishop³

et al. 2012

GaBI J

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Section: Review Articlementioning

confidence: 53%

Section: Review Articlementioning

confidence: 99%

European payer initiatives to reduce prescribing costs through use of generics

Godman¹,

Wettermark²,

Bishop³

et al. 2012

GaBI J

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“…High adherence rates at 80 to 90%% to the voluntary Wise List are enhanced by the involvement of prescribers in the selection process, a comprehensive communication program including a separate list for both patients and physicians, physician trust in the guidance, as well as regular feedback (24,65). Increased adherence also reduces costs (21,24,66). There are similar examples in Spain and Scotland (12,60,65).…”

Section: Discussionmentioning

confidence: 88%

“…Accumulated savings could increase to 49 million CNY with the attainment of generic prices similar to low prices achieved in some Western European countries. Simvastatin is recommended in the 'Wise List' in Stockholm County Council (66). In addition, SIGN (Scottish Intercollegiate Guidelines Network) in Scotland advocate the use of only 40 mg simvastatin for the prevention of cardiovascular disease (68,69) as well as for primary prevention of cardiovascular disease in patients with Type 1 diabetes.…”

Section: Discussionmentioning

confidence: 99%

Ongoing initiatives to improve prescribing efficiency in China; statins as a case history

Zhang

Godman

et al. 2014

GaBI J

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Introduction: Pharmaceutical expenditure rose by 16% per annum in China during the past decade, and now represents 46% of total health care expenditure. Initiatives to moderate growth include pricing regulations for pharmaceuticals and encouraging INN prescribing. However, there is limited monitoring of physician prescribing and current incentives encourage hospitals and physicians to profit from drug procurement. Objective: Assess changes in statin utilisation and expenditure as additional generics are launched. Subsequently, compare results in China with findings among European countries to provide future guidance. Methods: Observational retrospective study of statin utilisation and procurement expenditure from 2004 to 2013 in two large teaching hospital groups. Results: Statin utilisation rose 32 fold in one hospital group and 54 fold in the other. Expenditure also increased but to a lesser extent, i.e. from just over CNY 0.65 million in 2004 to 15.3 million in 2013 in one hospital group and from CNY 0.49 to 19.3 million in the other. Atorvastatin (originator) was the most utilised statin. Utilisation of each generic statin was typically low, e.g. 10% in 2013 in one hospital group. Procurement prices fell over time, greatest for generic simvastatin (-74 to -91%) mirroring data from European countries. However, no increase in their prescribing was observed. In fact, a significant decrease in generic prescribing was seen in one hospital group between 2004 and 2013. Conclusion: There are considerable opportunities to improve prescribing efficiency in China based on European experience. However, current incentives encouraging hospitals and physicians to profit from drug procurement need to be addressed.

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“…This could potentially reduce adverse drug reactions and drug: drug [52][53][54][55]. Research findings have also shown that increased adherence to the Wise List also reduces costs since medicines that have the most robust data tend to be well established medicines [52,55,56]. There are similar examples in Spain and Scotland [9,10,53].…”

mentioning

confidence: 78%

Analysis of the influence of recent reforms in China: cardiovascular and cerebrovascular medicines as a case history to provide future direction

Zhang

Zhen

Feng

et al. 2014

J. Compar. Effect. Res.

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Potential savings without compromising the quality of care

Abstract: A substantial amount of money can be saved in primary care without compromising the quality of care by using recommended first-line drugs for the treatment diabetes, hypertension and hypercholesterolaemia.

Cited by 49 publications

References 40 publications

European payer initiatives to reduce prescribing costs through use of generics

European payer initiatives to reduce prescribing costs through use of generics

Ongoing initiatives to improve prescribing efficiency in China; statins as a case history

Analysis of the influence of recent reforms in China: cardiovascular and cerebrovascular medicines as a case history to provide future direction

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