Ongoing activities to optimize the quality and efficiency of lipid-lowering agents in the Scottish national health service: influence and implications

Expert Review of Pharmacoeconomics & Outcomes Research
Axel LeporowskiAlec Morton

Abstract

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. Assessment of utilization (items dispensed) and expenditure of key LLAs (mainly statins) between 2001 and 2015 in Scotland alongside initiatives. Multiple interventions over the years have increased international nonproprietary name 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 expenditure of LLAs 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. Generic availability coupled with multiple measures has resulted in apprecia...Continue Reading

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Citations

Dec 8, 2019·Expert Review of Pharmacoeconomics & Outcomes Research·András Inotai, Zoltán Kaló
May 1, 2020·British Journal of Clinical Pharmacology·Renata Cristina Rezende Macedo do NascimentoAmanj Kurdi
May 26, 2021·Journal of Comparative Effectiveness Research·Mariana M BarbosaJuliana Alvares-Teodoro
Jul 10, 2021·Journal of Comparative Effectiveness Research·Brian GodmanJohanna C Meyer

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