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Consumer Reports Analysis

Medicare, Taxpayers Could Save $8.2 Billion a Year if Seniors Prescribed Generics for Cholesterol Reduction

Statins are widely prescribed; two brands will become available as generics this year

Jan. 12, 2006 - Potential savings of $8.2 billion could be achieved in 2007 if Medicare beneficiaries were prescribed effective, lower-cost generic statins to reduce cholesterol instead of higher-priced brands, according to a new analysis by Consumers Union and Consumer Reports Best Buy Drugs. The savings would accrue to taxpayers, Medicare drugs plans, and beneficiaries themselves.

“Lower-cost cholesterol drugs are just as effective and safe, and the savings from switching to them could be dramatic,” said Gail Shearer, Consumer Reports Best Buy Drugs project director. The independent, public education project uses analyses of the scientific evidence to recommend “Best Buys” in prescription drugs based on safety, effectiveness, and price.

Statins are among the most widely prescribed medicines in the country. They are used to treat elevated cholesterol and heart disease. In 2004, two statins – atorvastatin (Lipitor) and simvastatin (Zocor) – were respectively the No. 1 and No. 2 best-selling drugs in the country. Lipitor was also the most widely prescribed.

The analysis projects that the cost of statins under the new Medicare drug benefit – and to Medicare beneficiaries paying out of pocket – could be as high as $215 billion between 2006 and 2015, equaling 11 percent of all Medicare Part D drug spending over the decade.

In 2007, statin expenditures for and by Medicare beneficiaries are projected at $14 billion. That amount could be slashed by $8.2 billon – or 58 percent – by prescribing lower-cost generic statins, the analysis projects.

“For the Medicare drug benefit to continue without breaking the federal budget, it will be critical that medicines are prescribed based on their effectiveness and track record, not on advertising campaigns,” Shearer said.

The new analysis also found that statin prescriptions rose 2.6 percent from November 2004 to October 2005. Several brand-name statins experienced declining prescriptions, including Lescol and Pravachol. Lipitor prescriptions were flat while prescriptions for Vytorin more than doubled. Generic lovastatin prescriptions were up 15.2 percent.

Prices rose modestly (3% to 8%) for most of the statins during this period, although many at a faster rate than general (3.5%) or healthcare (4.5%) inflation, the analysis shows. Generic lovastatin was the only statin whose price (for the two most widely prescribed doses) declined during the period examined – by 5.2 percent.

The $8.2 billion in Medicare savings assumes potential obstacles to drug switches. For example, it presumes a 50 percent switch to generic simvastatin – now available only as brand-name Zocor – from other brand-name statins. Zocor is due to lose patent protection in June 2006 and generic versions are widely anticipated to be immediately available at lower cost. The analysis also assumes that all statin-taking beneficiaries needing modest cholesterol reduction would be switched to generic lovastatin from high-cost, brand-name statins. Lovastatin is the least expensive statin now on the market and could well remain so into 2006 and 2007. It is a Consumer Reports Best Buy Drug for people who need modest cholesterol reduction (less than 30 percent).

Lipitor is the Best Buy drug for people whose cholesterol is more significantly elevated or who are at higher risk of heart attack and stroke and need a more potent statin. Both drugs are picked in an updated report on statins being posted today at www.CRBestBuyDrugs.org, the project’s free Web site. The report will be updated again this summer when Zocor and another statin, Pravachol, go generic. The report discusses and compares the seven statins now available, including Vytorin, the latest entry in the statin market. It presents unbiased information on who needs to take a statin. Among the advice: people whose cholesterol is only marginally elevated may not need a statin; dietary changes may be enough to lower their “bad” (LDL – low density lipoprotein) cholesterol.

Information for consumers on ways to lower cholesterol and heart disease risk can also be found at www.ConsumerReportsMedicalGuide.org, Consumers Union’s subscription Web site that presents a comprehensive array of treatment options for 100 medical conditions, and the strength of the evidence on each option.

Consumer Reports Best Buy Drugs is a free, grant-funded public information project administered by Consumers Union. The reports are based on an independent, scientific review of available medical evidence by the Drug Effectiveness Review Project, a 14-state initiative based at the Oregon Health & Science University. The initiative compares drugs on effectiveness and safety for state Medicaid programs. Consumer Reports Best Buy Drugs combines those reviews with available medical and pricing information to identify Best Buys in each category.

Consumer Reports Best Buy Drugs is designed to help patients – in consultation with their doctors – find effective, safe, and affordable medicines. The project is supported by the Engelberg Foundation, a private philanthropy, and the National Library of Medicine of the National Institutes of Health.

Click here to download the complete analysis

Click here to Consumer Reports Medicare Part D Guide

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