Maybe cheaper isn't better.

Implications: An analysis of a study looking at the effects of switching patients from Lipitor® to generic simvastatin was presented recently at the European Society of Cardiology Congress 2007. The data was generated from a retrospective analysis of 11,520 patients, 2,511 of whom were switched from Lipitor® to generic simvastatin after having been on Lipitor® for 6 or more months. The analysis indicated that patients switched to simvastatin had a 30 percent increase in the relative risk of a major cardiovascular event. A seconday analysis of the same data showed that patients switched from Lipitor® to simvastatin were twice as likely to discontinue therapy, though the reasons were not elucidated. While the study was merely an observational study, the results do raise the question: Is it safe to indiscriminately switch patients from drugs such as Lipitor® to less expensive generic alternatives. I appears further studies are warranted.

Analysis: While it is too early to determine the effect this will have on formularies and prescribing habits, it has the potential to have a negative impact on the generic cholesterol-lowering drug market.

Many health plans, including State Medicaid programs require less expensive generics to higher-priced brand name drugs. Some require step therapy where patients have to start on the least expensive drug in a therapuetic category and are only alllowed to receive more expensive drugs if they fail on the initial therapy. While this may seem prudent, this study at least should cause us to pause and further evaluate the data.