Heart patients lives put at risk in switch to cheaper drugs
The Government’s drive to switch patients to cheaper statins could put lives at risk, new research has shown.
A study indicated that one third of patients who were switched from a branded statin to a cheaper generic one received a less powerful equivalent.
Those switched from Lipitor, known as atorvastatin, to a generic simvastatin would see their levels of dangerous “bad” cholesterol rise by between five and six per cent.
This could increase their risk of suffering a heart attack or stoke by about three per cent, said experts from the University of Melbourne.
In Britain, about five million people are on statins, which combat cardiovascular diseases. The Government has encouraged doctors to switch patients to generic drugs for several years. It means hundreds of patients could be at greater risk because they have been put on a less potent drug.
“This is a warning not just to look at the cost of medicines. You might be saving money but you could be losing a life,” said Lieven Annemans, a professor of health economics, at the European Society of Cardiology Congress in Stockholm.
The NHS spends twice as much on Lipitor than it does on simvastatin, despite fewer people taking the branded drug. A month’s supply of tablets of Lipitor costs about £26 per patient, whereas the equivalent cost of simvastatin is £2.
Prof Danny Liew, of Melbourne University, who led the latest study, said some research suggested that a triple dose of simvastatin was needed to be equivalent to Lipitor. “We must be careful about non-equivalent switching because of the potential for increasing cardiovascular disease risk and patients need to be aware of the difference in potency of different statins,” he said.
Branded drugs can be made only by the company that holds the patent and Pfizer makes Lipitor. After the patent has expired, the drug becomes “generic” and can be made by any manufacturer, meaning the price drops substantially. About eight in every 10 drugs prescribed by GPs in England are generics and statins, in particular, have been targeted by policy-makers to reduce costs.
A 10mg daily dose of Lipitor produces a 38 per cent reduction in bad cholesterol, whereas 10mg of simvastatin produces a 28 per cent drop.
Many British doctors are reluctant merely to increase the dose of a generic drug because of the risk of side effects. Statins can induce muscle aches, dizziness and headaches, and have been linked to kidney and liver problems.
Prof Liew studied data from almost 40,000 patients in Holland who were switched from Lipitor to simvastatin in the first three months of 2009. One third of patients ended up with a lower equivalent dose of simvastatin. The study was funded by Pfizer.
Dr Jeremy Pearson of the British Heart Foundation said: “It is clear that GPs need to be informed that you cannot switch 20mg of one for 20mg of another.
“Switching cannot be done thoughtlessly, otherwise you are at risk of doing something that is not advantageous to your patient at all.”
Tags: Heart Disease, NHS Deaths, preventable crisis, red tape