Philadelphia College of Pharmacy, University of the Sciences, Philadelphia, PA 19104, USA.
Int J Clin Pract. 2010 Aug;64(9):1235-8. doi: 10.1111/j.1742-1241.2010.02423.x.
The introduction of a generic formulation of simvastatin has created the potential to provide significant low-density lipoprotein cholesterol (LDL-C) reduction in a highly cost-effective manner.
This retrospective cohort analysis utilised electronic medical record data from a United States, community-based, independent physician family medicine practice. Patients switched from other statins or statin combinations to simvastatin by the family medicine physicians during routine patient care from January 2002 to October 2008 were identified. Equivalent statin dosing, lipid panel changes and National Cholesterol Education Program--Adult Treatment Panel III (NCEP) LDL-C goal attainment rates were compared preswitch and postswitch. The potential economic impact of simvastatin switching was also evaluated.
A total of 78 patients were identified, and in 76.9% of the switches, an equipotent dose of simvastatin was prescribed. All lipid fractions showed small, non-significant increases, with LDL-C having a 2.2 mg/dl (0.06 mmol/l) increase after switching (p = 0.476). NCEP LDL-C goal attainment rates were 79.5% and 78.2% before and after switching, respectively (p = 1.00). Modelled annual cost savings associated with switching were estimated at $671.99 per patient.
These results demonstrate that an independent family medicine physician practice can successfully perform statin therapeutic substitution during routine patient care. Equivalent clinical outcomes with regards to changes in lipid fractions and NCEP LDL-C goal attainment were observed in conjunction with the potential for reduced costs for patients.
辛伐他汀的通用配方的引入创造了以极具成本效益的方式提供显著降低低密度脂蛋白胆固醇（LDL-C）的潜力。
本回顾性队列分析利用了美国一家社区独立医生家庭医学实践的电子病历数据。在 2002 年 1 月至 2008 年 10 月期间，家庭医生在常规患者护理过程中，让患者从其他他汀类药物或他汀类药物联合治疗转换为辛伐他汀。比较了转换前后等效他汀类药物剂量、血脂谱变化和国家胆固醇教育计划-成人治疗专家组 III（NCEP）LDL-C 目标达标率。还评估了辛伐他汀转换的潜在经济影响。
共确定了 78 名患者，在 76.9%的转换中，开具了等效剂量的辛伐他汀。所有血脂成分均显示出较小的、无统计学意义的增加，LDL-C 在转换后增加了 2.2mg/dl（0.06mmol/l）（p=0.476）。转换前后 NCEP LDL-C 目标达标率分别为 79.5%和 78.2%（p=1.00）。估计与转换相关的每年节省成本为每位患者 671.99 美元。
这些结果表明，独立的家庭医生实践可以在常规患者护理期间成功进行他汀类药物治疗替代。观察到血脂成分变化和 NCEP LDL-C 目标达标方面的等效临床结果，同时也为患者节省了潜在成本。
