The Value of Atorvastatin Over the Product Life Cycle in the United States

Michael Grabner, Wallace Johnson, Abdulla M. Abdulhalim, Andreas Kuznik, C. Daniel Mullins

Research output: Contribution to journalArticle

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 languageEnglish (US)
Pages (from-to)1433-1443
Number of pages11
JournalClinical Therapeutics
Volume33
Issue number10
DOIs
StatePublished - Oct 2011
Externally publishedYes

Fingerprint

Life Cycle Stages
Cost-Benefit Analysis
Simvastatin
Quality-Adjusted Life Years
Pharmaceutical Preparations
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Health Insurance Reimbursement
Atorvastatin Calcium
Costs and Cost Analysis
Health Care Reform
Cost Savings
Nutrition Surveys
Quality of Health Care
Primary Prevention
Health Expenditures
Secondary Prevention
Delivery of Health Care
Lipids

Keywords

  • Atorvastatin
  • Drug product life cycle
  • Health care costs
  • Me-too drugs
  • Simvastatin
  • Statins

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)

Cite this

Grabner, M., Johnson, W., Abdulhalim, A. M., Kuznik, A., & Mullins, C. D. (2011). The Value of Atorvastatin Over the Product Life Cycle in the United States. Clinical Therapeutics, 33(10), 1433-1443. https://doi.org/10.1016/j.clinthera.2011.08.014

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 journalArticle

Grabner, M, Johnson, W, Abdulhalim, AM, Kuznik, A & Mullins, CD 2011, 'The Value of Atorvastatin Over the Product Life Cycle in the United States', Clinical Therapeutics, vol. 33, no. 10, pp. 1433-1443. https://doi.org/10.1016/j.clinthera.2011.08.014
Grabner, Michael ; Johnson, Wallace ; Abdulhalim, Abdulla M. ; Kuznik, Andreas ; Mullins, C. Daniel. / The Value of Atorvastatin Over the Product Life Cycle in the United States. In: Clinical Therapeutics. 2011 ; Vol. 33, No. 10. pp. 1433-1443.
@article{b02c884b8f8e47ed86c70f8dee957a24,
title = "The Value of Atorvastatin Over the Product Life Cycle in the United States",
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.",
keywords = "Atorvastatin, Drug product life cycle, Health care costs, Me-too drugs, Simvastatin, Statins",
author = "Michael Grabner and Wallace Johnson and Abdulhalim, {Abdulla M.} and Andreas Kuznik and Mullins, {C. Daniel}",
year = "2011",
month = "10",
doi = "10.1016/j.clinthera.2011.08.014",
language = "English (US)",
volume = "33",
pages = "1433--1443",
journal = "Clinical Therapeutics",
issn = "0149-2918",
publisher = "Excerpta Medica",
number = "10",

}

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 -