Abstract | BACKGROUND: The statin authorisation form implemented in the Netherlands in January 2009 has led to significant switching of patients from atorvastatin to generic simvastatin, but often to less than equipotent doses. We sought to assess the potential consequences of this. METHODS: RESULTS: In the first quarter of 2009, 33.7%, 47.2% and 19.1% of Dutch patients initially on atorvastatin were switched to less potent, equipotent and more potent doses of simvastatin, respectively. The net effect was estimated to be a 6.8% increase in LDL-C. Assuming a pre-switch LDL-C of 2 mmol/L, the predicted relative increases (95%CI) in the risks of all-cause mortality and major cardiovascular events were 1.7% (0.9%-2.6%) and 2.8% (1.6%-4.1%), respectively. CONCLUSIONS: In the Netherlands, policy-driven switching from atorvastatin to generic simvastatin led overall to less potent doses being used, with possible significant clinical implications.
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Authors | D Liew, K Webb, W-J Meerding, E Buskens, J W Jukema |
Journal | Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
(Neth Heart J)
Vol. 20
Issue 5
Pg. 197-201
(May 2012)
ISSN: 1876-6250 [Electronic] Netherlands |
PMID | 22231155
(Publication Type: Journal Article)
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