Abstract
Background: US health care reform mandates the reduction of wasteful health care spending while maintaining quality of care. Introducing new drugs into crowded therapeutic classes may be viewed as offering "me-too" (new drugs with a similar mechanism of action compared to existing drugs) drugs without incremental benefit. This article presents an analysis of the incremental costs and benefits of atorvastatin, a lipid-lowering agent. Objective: This analysis models the cost-effectiveness of atorvastatin over the product life cycle. Methods: The yearly cost-effectiveness of atorvastatin compared to simvastatin was modeled from 1997 to 2030 from the point of view of a US third-party payer. Estimates for incremental costs (in US $) and effects (in quality-adjusted life-years [QALYs]) for the primary and secondary prevention of cardiovascular events were taken from previously published literature and adjusted for changes in drug prices over time. Estimates of total statin use were derived using the National Health and Nutrition Examination Survey. Sensitivity analyses were conducted to examine variations in study parameters, including drug prices, indications, and discount rates. Results: Assuming increasing statin use over time (with a mean of 1.07 million new users per year) and a 3% discount rate, the cumulative incremental cost-effectiveness ratio (ICER) of atorvastatin versus simvastatin ranged from cost-savings at release to a maximum of $45,066/QALY after 6 years of generic simvastatin use in 2012. Over the full modeled life cycle (1997-2030), the cumulative ICER of atorvastatin was $20,331/QALY. The incremental value of atorvastatin to US payers (after subtracting costs) was estimated at $44.57 to $194.78 billion, depending on willingness to pay. Findings from the sensitivity analyses were similar. A hypothetical situation in which atorvastatin did not exist was associated with a reduction in total expenditures but also a loss of QALYs gained. Conclusion: The cumulative ICER of atorvastatin varied across the product life cycle, increasing during the period between generic simvastatin entry and generic atorvastatin entry, and decreasing thereafter.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1433-1443 |
| Number of pages | 11 |
| Journal | Clinical Therapeutics |
| Volume | 33 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 2011 |
| Externally published | Yes |
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Keywords
- Atorvastatin
- Drug product life cycle
- Health care costs
- Me-too drugs
- Simvastatin
- Statins
ASJC Scopus subject areas
- Pharmacology
- Pharmacology (medical)
Cite this
The Value of Atorvastatin Over the Product Life Cycle in the United States. / Grabner, Michael; Johnson, Wallace; Abdulhalim, Abdulla M.; Kuznik, Andreas; Mullins, C. Daniel.
In: Clinical Therapeutics, Vol. 33, No. 10, 10.2011, p. 1433-1443.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The Value of Atorvastatin Over the Product Life Cycle in the United States
AU - Grabner, Michael
AU - Johnson, Wallace
AU - Abdulhalim, Abdulla M.
AU - Kuznik, Andreas
AU - Mullins, C. Daniel
PY - 2011/10
Y1 - 2011/10
N2 - Background: US health care reform mandates the reduction of wasteful health care spending while maintaining quality of care. Introducing new drugs into crowded therapeutic classes may be viewed as offering "me-too" (new drugs with a similar mechanism of action compared to existing drugs) drugs without incremental benefit. This article presents an analysis of the incremental costs and benefits of atorvastatin, a lipid-lowering agent. Objective: This analysis models the cost-effectiveness of atorvastatin over the product life cycle. Methods: The yearly cost-effectiveness of atorvastatin compared to simvastatin was modeled from 1997 to 2030 from the point of view of a US third-party payer. Estimates for incremental costs (in US $) and effects (in quality-adjusted life-years [QALYs]) for the primary and secondary prevention of cardiovascular events were taken from previously published literature and adjusted for changes in drug prices over time. Estimates of total statin use were derived using the National Health and Nutrition Examination Survey. Sensitivity analyses were conducted to examine variations in study parameters, including drug prices, indications, and discount rates. Results: Assuming increasing statin use over time (with a mean of 1.07 million new users per year) and a 3% discount rate, the cumulative incremental cost-effectiveness ratio (ICER) of atorvastatin versus simvastatin ranged from cost-savings at release to a maximum of $45,066/QALY after 6 years of generic simvastatin use in 2012. Over the full modeled life cycle (1997-2030), the cumulative ICER of atorvastatin was $20,331/QALY. The incremental value of atorvastatin to US payers (after subtracting costs) was estimated at $44.57 to $194.78 billion, depending on willingness to pay. Findings from the sensitivity analyses were similar. A hypothetical situation in which atorvastatin did not exist was associated with a reduction in total expenditures but also a loss of QALYs gained. Conclusion: The cumulative ICER of atorvastatin varied across the product life cycle, increasing during the period between generic simvastatin entry and generic atorvastatin entry, and decreasing thereafter.
AB - Background: US health care reform mandates the reduction of wasteful health care spending while maintaining quality of care. Introducing new drugs into crowded therapeutic classes may be viewed as offering "me-too" (new drugs with a similar mechanism of action compared to existing drugs) drugs without incremental benefit. This article presents an analysis of the incremental costs and benefits of atorvastatin, a lipid-lowering agent. Objective: This analysis models the cost-effectiveness of atorvastatin over the product life cycle. Methods: The yearly cost-effectiveness of atorvastatin compared to simvastatin was modeled from 1997 to 2030 from the point of view of a US third-party payer. Estimates for incremental costs (in US $) and effects (in quality-adjusted life-years [QALYs]) for the primary and secondary prevention of cardiovascular events were taken from previously published literature and adjusted for changes in drug prices over time. Estimates of total statin use were derived using the National Health and Nutrition Examination Survey. Sensitivity analyses were conducted to examine variations in study parameters, including drug prices, indications, and discount rates. Results: Assuming increasing statin use over time (with a mean of 1.07 million new users per year) and a 3% discount rate, the cumulative incremental cost-effectiveness ratio (ICER) of atorvastatin versus simvastatin ranged from cost-savings at release to a maximum of $45,066/QALY after 6 years of generic simvastatin use in 2012. Over the full modeled life cycle (1997-2030), the cumulative ICER of atorvastatin was $20,331/QALY. The incremental value of atorvastatin to US payers (after subtracting costs) was estimated at $44.57 to $194.78 billion, depending on willingness to pay. Findings from the sensitivity analyses were similar. A hypothetical situation in which atorvastatin did not exist was associated with a reduction in total expenditures but also a loss of QALYs gained. Conclusion: The cumulative ICER of atorvastatin varied across the product life cycle, increasing during the period between generic simvastatin entry and generic atorvastatin entry, and decreasing thereafter.
KW - Atorvastatin
KW - Drug product life cycle
KW - Health care costs
KW - Me-too drugs
KW - Simvastatin
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=80054901814&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80054901814&partnerID=8YFLogxK
U2 - 10.1016/j.clinthera.2011.08.014
DO - 10.1016/j.clinthera.2011.08.014
M3 - Article
C2 - 21955936
AN - SCOPUS:80054901814
VL - 33
SP - 1433
EP - 1443
JO - Clinical Therapeutics
JF - Clinical Therapeutics
SN - 0149-2918
IS - 10
ER -