Study: Patients have better health outcomes with generic statins as opposed to brand-name statins

Dr Gagne

Initiating statin therapy with a generic instead of a brand-name version was associated with lower out-of-pocket spending, better medication adherence, and better health outcomes, according to a study published recently in the Annals of Internal Medicine.

Lead study author Joshua J. Gagne, PharmD, ScD, and colleagues from Brigham and Women’s Hospital (BWH), Harvard Medical School and CVS Health investigated whether the use of generic versus brand-name statins can play a role in medication adherence and whether or not this leads to improved health outcomes.

More research from BWH and CVS Health

The researchers conducted an observational cohort study among Medicare beneficiaries to compare adherence and clinical outcomes between generic statin initiators and brand-name statin initiators.  

“We used propensity score matching to address differences in characteristics between generic and brand-name statin initiators,” said Dr Gagne, assistant professor of medicine in BWH’s Division of Pharmacoepidemiology and Pharmacoeconomics.

“Adherence was measured using the proportion of days covered metric and the primary clinical outcome was a composite measure comprising acute coronary syndrome, stroke, and death,” he said.

The researchers used electronic data from medical and pharmacy claims and looked at Medicare beneficiaries aged 65 years or older with prescription drug coverage between 2006 and 2008. They measured adherence to statin therapy and outcomes comprising of hospitalization for an acute coronary syndrome, stroke and mortality. In this head-to-head comparison, they found that patients initiating generic statins were more likely than those initiating brand-name statins to adhere to their prescribed treatment and had an eight percent lower rate of cardiovascular events and death.

 
“Generic drug use has been widely recognized to reduce patient out-of-pocket costs and payer spending. Among patients in our study, the mean copayment for the generic statin was $10 and $48 for brand-name statins,” explained Gagne. “Our finding that adherence is greater with generic statins is consistent with other studies that have shown a direct relation between higher copayments and lower adherence.”

Dr Gagne and colleagues concluded that in the setting of tiered copayments in typical pharmacy benefit designs, initiating generic versus name-brand statins seems to be associated with lower out-of-pocket costs, improved adherence to therapy and improved clinical outcomes.  

“Encouraging use of generic drugs not only reduces drug spending, but can also promote medication adherence, which can lead to better health outcomes for patients,” said Dr Gagne.  

“There is evidence to suggest that lower out-of-pocket drug spending is associated with better medication adherence and evidence to suggest that better medication adherence is associated with better health outcomes,” he said. “Generic drugs usually cost less than their brand-name counterparts, but no study had yet examined whether using generic drugs instead of brand-name versions results in better health outcomes.” 

As the United States strives to transform the healthcare system and identify strategies to promote improved health outcomes at lower costs, one well-supported solution is to initiate therapy for cardiovascular disease with generic drugs, according to Dr Gagne. 

“In the setting of tiered copayments in typical pharmacy benefit designs, using generics appears to be associated with lower out-of-pocket costs, improved adherence to therapy, and improved clinical outcomes,” he said.