Abstract
| Language | English |
|---|---|
| Pages | 655-666 |
| Number of pages | 12 |
| Journal | Expert Review of Pharmacoeconomics and Outcomes Research |
| Volume | 18 |
| Issue number | 6 |
| Early online date | 3 Aug 2018 |
| DOIs | |
| Publication status | Published - 10 Oct 2018 |
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Keywords
- lipid lowering agents
- Scottish NHS
- expenditure
- reforms
- drug utilisation
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Ongoing activities to optimize the quality and efficiency of lipid-lowering agents in the Scottish National Health System : influence and implications. / Leporowski, Axel; Godman, Brian; Kurdi, Amanj; MacBride-Stewart, Sean; Ryan, Margaret ; Hurding, Simon; do Nascimento, Renata CRM; Bennie, Marion; Morton, Alec.
In: Expert Review of Pharmacoeconomics and Outcomes Research, Vol. 18, No. 6, 10.10.2018, p. 655-666.Research output: Contribution to journal › Article
TY - JOUR
T1 - Ongoing activities to optimize the quality and efficiency of lipid-lowering agents in the Scottish National Health System
T2 - Expert Review of Pharmacoeconomics and Outcomes Research
AU - Leporowski, Axel
AU - Godman, Brian
AU - Kurdi, Amanj
AU - MacBride-Stewart, Sean
AU - Ryan, Margaret
AU - Hurding, Simon
AU - do Nascimento, Renata CRM
AU - Bennie, Marion
AU - Morton, Alec
PY - 2018/10/10
Y1 - 2018/10/10
N2 - Introduction and aims: Prescribing of lipid lowering agents (LLAs) has increased worldwide including in Scotland with increasing prevalence of coronary heart disease, and higher dose statins have been advocated in recent years. There have also been initiatives to encourage prescribing of generic versus patented statins to save costs without compromising care. There is a need to document these initiatives and outcomes to provide future direction. Method: Assessment of utilization (items dispensed) and expenditure of key LLAs (mainly statins) and expenditure between 2001 and 2015 in Scotland alongside initiatives. Results: Multiple interventions have increased international non-proprietary name (INN) prescribing (99% for statins) and preferential prescribing of generic versus patented statins, and reduced inappropriate prescribing of ezetimibe. This resulted in a 50% reduction in LLA expenditure between 2001 and 2015 despite a 412% increase in utilization, increased prescribing of higher dose statins (71% in 2015) especially atorvastatin following generic availability, and reduced prescribing of ezetimibe (reduced by 72% between 2010 and 2015). As a result, the quality of prescribing has improved. Conclusion: Generic availability coupled with multiple measures has resulted in appreciable shifts in statin prescribing behavior and reducing ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing.
AB - Introduction and aims: Prescribing of lipid lowering agents (LLAs) has increased worldwide including in Scotland with increasing prevalence of coronary heart disease, and higher dose statins have been advocated in recent years. There have also been initiatives to encourage prescribing of generic versus patented statins to save costs without compromising care. There is a need to document these initiatives and outcomes to provide future direction. Method: Assessment of utilization (items dispensed) and expenditure of key LLAs (mainly statins) and expenditure between 2001 and 2015 in Scotland alongside initiatives. Results: Multiple interventions have increased international non-proprietary name (INN) prescribing (99% for statins) and preferential prescribing of generic versus patented statins, and reduced inappropriate prescribing of ezetimibe. This resulted in a 50% reduction in LLA expenditure between 2001 and 2015 despite a 412% increase in utilization, increased prescribing of higher dose statins (71% in 2015) especially atorvastatin following generic availability, and reduced prescribing of ezetimibe (reduced by 72% between 2010 and 2015). As a result, the quality of prescribing has improved. Conclusion: Generic availability coupled with multiple measures has resulted in appreciable shifts in statin prescribing behavior and reducing ezetimibe prescribing, resulting in improvements in both the quality and efficiency of prescribing.
KW - lipid lowering agents
KW - Scottish NHS
KW - expenditure
KW - reforms
KW - drug utilisation
UR - https://tandfonline.com/toc/ierp20/current
U2 - 10.1080/14737167.2018.1501558
DO - 10.1080/14737167.2018.1501558
M3 - Article
VL - 18
SP - 655
EP - 666
JO - Expert Review of Pharmacoeconomics and Outcomes Research
JF - Expert Review of Pharmacoeconomics and Outcomes Research
SN - 1473-7167
IS - 6
ER -