Generic Atorvastatin and Health Care Costs

Study Questions:

What are the health care cost implications of generic atorvastatin?

Methods:

The authors used information on the past and current market share of various statins including Lipitor, and the changes in statin use after simvastatin became generic, to estimate costs related to generic atorvastatin.

Results:

Lipitor was the top-selling prescription medication in the United States in 2010. Lipitor, Crestor, and generic simvastatin account for 77% of the statin market as of 2009. Current market shares are estimated to be 21% for Lipitor and 51% for simvastatin. The authors project that generic atorvastatin will dominate the statin market, with an estimated 44% of the market by 2015. The first generic version of atorvastatin entered the market in November of 2011. Generic simvastatin was 16% less than the average brand name price 1 month after generic simvastatin became available, but then dropped to 60% less after 12 months. Based on this, the authors project that the price reduction of generic atorvastatin will be 0.49 after 6 months from the time it became available. The overall cost savings is projected at $4.5 billion annually by 2014, the equivalent to 23% of total expenditures on statins in that year. The projected cost savings will increase by $10 million annually in 2012 to $30 million annually in 2014. Meanwhile, Pfizer has contracted with Watson Pharmaceuticals to provide Watson with Lipitor to sell without brand name but at generic prices, in return for a share of the profits. This allows Lipitor to compete with other generic forms of atorvastatin. Additional contracts with pharmacy-benefits management and insurance companies will allow Pfizer to retain a larger market share for Lipitor. Pfizer has also launched a $4 copay card for consumers to buy Lipitor at comparable cost to generic statins (i.e., no higher copays). Although consumers are not directly paying an increased cost, they are likely going to pay a higher cost indirectly, by purchasing the nongeneric brand name drug.

Conclusions:

The authors concluded that education of consumers and clinicians regarding the marketing tactics of companies who are stakeholders in the selling of nongeneric drugs like Lipitor is critical to keeping health care costs in check. In addition, they urge the rapid adoption of generics such as generic atorvastatin, to maximize health care savings as soon as generic forms of medications are available.

Perspective:

This thoughtful, well-written paper outlines some of the major implications of generic medications. The billions of dollars of cost savings from generic medications, such as generic atorvastatin, will be a key component of strategies to reduce health care costs.

Keywords: Pyrroles, Fluorobenzenes, Cardiology, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Pyrimidines, Health Care Costs, Cost Savings, Heptanoic Acids, Simvastatin, United States, Sulfonamides


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