If you live in the U.S. and take a statin to lower your cholesterol, you're paying a premium price for that drug.
That's the conclusion of the Boston University School of Medicine (BUSM) Boston Collaborative Drug Surveillance Program, which found the cost of statins for people in the U.S. 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.
The cost of prescription drugs remains a large part of the ongoing debate on the costs of medical care in the U.S. and U.K. Because of the many 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, the researchers said.
Statins are popular but have rare and potentially severe adverse effects, particularly muscle damage, and some doctors believe they are overprescribed. A 2010 Johns Hopkins study of 950 healthy men and women has shown that taking daily doses of a statin medication to protect coronary arteries might not provide additional protection.
Lipitor, one of the most widely prescribed statins, just went generic, but it may be a few years before its price falls significantly. It's price before going generic was well over $1,000 a year.
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 you don't pay, you don't care what it costs
Are American patients that much richer than their British counterparts, that they can afford to shell out $1,400 a year for a prescription drug? Not really. But the point is, they aren't paying for it directly. With so many health plans now providing prescription coverage, American patients often get very expensive drugs for a low co-pay. The actual cost is reflected in higher premiums and shifted to patients without drug coverage.
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.
Generics prove popular
According to the researchers, simvastin was approved in the U.S. for sale in generic formulation in late June 2006. Within the next six months more than 60 percent of users switched from the brand preparation to the generic.
The resulting estimated cost was reduced more than 60 percent. According to the researchers, however, it still was four times higher than that in the UK.