부산대학교 도서관

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1365-2125.2007.02907.x Byline: Solveig Sakshaug (1), Kari Furu (1), Oystein Karlstad (1), Marit Ronning (1), Svetlana Skurtveit (12) Keywords: adherence to regulations; drug costs; Norway; pharmacoepidemiology; prescription database; statins Abstract: What is already known about this subject * Use of statins is growing worldwide and costs represent a burden to public budgets. * The introduction of simvastatin generics, generic substitution and price regulations have contributed to price reductions and resulted in overall cost reductions of statin use in Norway. What this study adds * New reimbursement regulations for statins in Norway in June 2005, making simvastatin the drug of choice, had a great impact on physicians' prescribing of statins. * Nearly 40% of the atorvastatin users switched to simvastatin during the 13-month period after implementation of the new regulations. * Among the new users of statins the proportion receiving simvastatin increased from 48% in May 2005 to 92% in June 2006. * The new regulations have reduced costs of statins, even though the prevalence of statin use has increased. Aims To assess the changes in prescribing of statins in Norway after implementation of the new reimbursement regulations for statins in June 2005. Methods Data were retrieved from the Norwegian Prescription Database covering the total population in Norway (4.6 million). Outcome measures were the proportion of atorvastatin users switching to simvastatin and changes in the proportion of new statin users receiving simvastatin. Based on retail costs for all statin prescriptions dispensed in Norway, expenditure was measured in Norwegian currency. Results One-year prevalences of statin use increased from 6.3 to 6.8% for women and from 7.5 to 8.1% for men from the year before to the year after the new statin regulations. Of atorvastatin users (N = 131 222), 39% switched to simvastatin during the 13-month period after the implementation. The proportion of switching was higher in women (41%) than in men (36%). In May 2005, 48% of the new statin users received simvastatin. The proportion of new users receiving simvastatin increased rapidly after implementation of the new regulations to 68% in June 2005 and reached 92% in June 2006. Expenditure was reduced from &U20AC;120 million to &U20AC;95 million when comparing the year before with the year after the new statin regulations. Conclusions The new reimbursement policy for statins has had a great impact on physicians' prescribing of statins in Norway. Physicians in Norway acknowledge the importance of contributing to cost containment. Author Affiliation: (1)Department of Pharmacoepidemiology, Division of Epidemiology, Norwegian Institute of Public Health, Oslo and (2)Department of Pharmacy, University of Tromso, Tromso, Norway Article History: Received20 October 2006 Accepted26 January 2007Published OnlineEarly18 April 2007 Article note: Solveig Sakshaug, Department of Pharmacoepidemiology, Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404, Nydalen, N-0403 Oslo, Norway., Tel: + 47 23408142 , Fax: + 47 23408146, E-mail: solveig.sakshaug@fhi.no