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. 2017 Nov 25;12(1):141.
doi: 10.1186/s13012-017-0671-z.

The impact of a physician detailing and sampling program for generic atorvastatin: an interrupted time series analysis

Heather C Worthington  1   2 , Lucy Cheng  3 , Sumit R Majumdar  4 , Steven G Morgan  5 , Colette B Raymond  6 , Stephen B Soumerai  7 , Michael R Law  3
Affiliations

The impact of a physician detailing and sampling program for generic atorvastatin: an interrupted time series analysis

Heather C Worthington et al. Implement Sci. .

Abstract

Background: In 2011, Manitoba implemented a province-wide program of physician detailing and free sampling for generic atorvastatin to increase use of this generic statin. We examined the impact of this unique combined program of detailing and sampling for generic atorvastatin on the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin.

Methods: We conducted a retrospective study of Manitoba insurance claims data for all continuously enrolled patients who filled one or more prescriptions for a statin between 2008 and 2013. Data were linked to physician-level data on the number of detailing visits and sample provision. We used interrupted time series analyses to assess policy-related changes in the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin.

Results: The detailing program reached 31% (651/2103) of physicians who prescribed a statin during the study period. Collectively, these physicians prescribed 61% of statins dispensed in the province. Free sample cards were provided to 61% (394/651) of the detailed physicians. The program did not change the level or trend in the overall statin use rate and the total cost of statins or increase the number of patients switching from another branded statin to generic atorvastatin. We found the program had a small impact on atorvastatin's market share of new prescriptions, with a level increase of 2.6%.

Conclusions: Though physician detailers were skilled at targeting high-prescribing physicians, a combined program of detailing visits and sample provision for generic atorvastatin did not lower overall statin costs or lead to switching from branded statins to the generic. The preceding introduction of generic atorvastatin appeared sufficient to modify prescribing patterns and decrease costs.

Keywords: Atorvastatin; Detailing; Generic drugs; Sampling.

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Conflict of interest statement

Ethics approval and consent to participate

The University of British Columbia Behaviour Research Ethics Board (H13-00983) approved this study. As this study used administrative data, consent was not required.

Consent for publication

Not applicable.

Competing interests

Michael Law has consulted for Health Canada on unrelated pharmaceutical policy topics. All other authors declare no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Statin prescribing in Manitoba from 2008 to 2013
Fig. 2
Fig. 2
Total cost of statins in Manitoba from 2008 to 2013
Fig. 3
Fig. 3
Number of people who switched from a branded statin to generic atorvastatin from 2009 to 2013
Fig. 4
Fig. 4
Percent market share of new statin prescriptions in Manitoba from 2009 to 2013
See this image and copyright information in PMC

References

    1. Kesselheim AS, et al. Clinical equivalence of generic and brand-name drugs used in cardiovascular disease: a systematic review and meta-analysis. JAMA. 2008;300(21):2514–2526. doi: 10.1001/jama.2008.758. - DOI - PMC - PubMed
    1. Secor Consulting . Generic drug pricing and access in Canada: what are the implications? Toronto: Health Council of Canada; 2010.
    1. Canadian Institute for Health Information . Prescribed drug spending in Canada, 2013: a focus on public drug programs. 2015.
    1. Canadian Institute for Health Information . Health care cost drivers: the facts. Ottawa: Canadian Institute for Health Information; 2011.
    1. Wazana A. Physicians and the pharmaceutical industry: is a gift ever just a gift? JAMA. 2000;283(3):373–380. doi: 10.1001/jama.283.3.373. - DOI - PubMed

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