Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Massachusetts 02421, USA.
Pharmacotherapy. 2012 Jan;32(1):1-6. doi: 10.1002/PHAR.1005.
To compare the annual cost of statins in the United States and in the United Kingdom.
Matched-cohort cost analysis.
U.K. General Practice Research Database (GPRD), and MarketScan Commercial Claims and Encounters Database, a large, U.S. self-insured medical claims database.
We initially identified 1.6 million people in the GPRD who were younger than 65 years of age in 2005. These people were then matched by year of birth and sex with 1.6 million people in the U.S. database. From this matched pool, we estimated that 280,000 people aged 55-64 years from each country in 2005 were prescribed at least one drug. Of these, 91,474 (33%) in the U.S. were prescribed a statin compared with 68,217 (24%) in the U.K. After excluding those who did not receive statins continuously or who switched statins during the year, there remained 61,470 in the U.S. and 45,788 in the U.K. who were prescribed a single statin preparation continuously during 2005 (annual statin users). We estimated and compared drug costs (presented in 2005 U.S. dollars) separately in the two countries.
Estimated drug costs were determined by random sampling. Estimated annual costs/patient in the U.S. ranged from $313 for generic lovastatin to $1428 for nongeneric simvastatin. In the U.K., annual costs/patient ranged from $164 for generic simvastatin to $509 for nongeneric atorvastatin. The total annual cost of the continuous receipt of statins in the U.S. was $64.9 million compared with $15.7 million in the U.K. In June 2006, after our study results were analyzed, the U.S. Food and Drug Administration approved generic simvastatin. We thus derived cost estimates for simvastatin use during 2006 and found that more than 60% of simvastatin users switched to the generic product, which reduced the cost/pill by more than 50%.
The cost paid for statins in the U.S. for people younger than 65 years, who were insured by private companies, was approximately 400% higher than comparable costs paid by the government in the U.K. Available generic statins were substantially less expensive than those that were still under patent in both countries.
比较他汀类药物在美国和英国的年度成本。
匹配队列成本分析。
英国全科医生研究数据库（GPRD）和市场扫描商业索赔和遭遇数据库，这是一个大型的美国自保险医疗索赔数据库。
我们最初在 GPRD 中确定了 160 万人，他们在 2005 年时年龄小于 65 岁。然后，这些人与美国数据库中的 160 万人按出生年份和性别进行匹配。在这个匹配的人群中，我们估计两国 2005 年有 28 万名 55-64 岁的人至少开了一种药。其中，美国有 91474 人（33%）开了他汀类药物，而英国有 68217 人（24%）。在排除了那些没有连续服用他汀类药物或在一年内换用他汀类药物的人之后，美国仍有 61470 人，英国仍有 45788 人在 2005 年连续服用了一种他汀类药物（每年服用他汀类药物的患者）。我们分别在两个国家估算和比较药物成本（以 2005 年美元计算）。
通过随机抽样确定估计的药物成本。美国的估计年度每位患者的费用从通用洛伐他汀的 313 美元到非专利辛伐他汀的 1428 美元不等。在英国，每年每位患者的费用从通用辛伐他汀的 164 美元到非专利阿托伐他汀的 509 美元不等。美国连续服用他汀类药物的总年度费用为 6490 万美元，而英国为 1570 万美元。2006 年 6 月，在我们的研究结果分析后，美国食品和药物管理局批准了通用辛伐他汀。因此，我们得出了 2006 年辛伐他汀使用的成本估计，发现超过 60%的辛伐他汀使用者转而使用通用产品，这使每片药物的成本降低了 50%以上。
在美国，私人保险公司为 65 岁以下人群支付的他汀类药物费用比英国政府支付的类似费用高出约 400%。两国的仿制药他汀类药物价格明显低于仍在专利保护期内的药物。
