Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

UK could save a billion on cholesterol and blood pressure drugs without compromising healthcare

18.01.2007
Switching patients to more cost-effective drugs for cholesterol and blood pressure problems could save the UK’s National Health Service a billion pounds over the next five years without compromising clinical care, according to a study in the January issue of IJCP, the International Journal of Clinical Practice.

A research team led by Juliet Usher-Smith from the University of Cambridge, and Professor Mike Kirby from The Hertfordshire Primary Care Research Network looked at the clinical and financial implications of switching 185 patients at a family doctors’ practice to more cost-effective drugs.

The switch, at the practice in Hertfordshire, UK, was carried out at the request of the local Primary Care Trust, which funds family doctors in the area.

No adverse events were reported by either patient group and the researchers argue that if the £26,000 annual savings were replicated elsewhere in the UK, the cost savings would be significant.

“In this study the generic drug simvastastin replaced low dose atorvastastin for high cholesterol treatment and candesartan replaced losartan for treating high blood pressure” explains Juliet Usher-Smith.

“Four months after the switch the cholesterol lowering drug was performing in line with the previous drug and the new blood pressure drug had actually resulted in a small, but significant, reduction in blood pressure.”

Patients were only switched to alternative drugs after careful screening by both the practice pharmacist and doctors to ensure that there were no clinical reasons why this shouldn’t be done. All patients were informed of the plans before new prescriptions were issued, either by letter or at regular check-ups.

122 were being prescribed the cholesterol lowering drug atorvastatin at the time of the switch. 43 were excluded by the practice pharmacist or doctors. 70 (57 per cent) were switched to simvastatin and 69 (99 per cent) stayed on the new drug once they’d switched.

The patient who was switched back to atorvastatin reported experiencing visual symptoms at night on simvastatin.

The clinical outcome ten months after the switch was positive. There was no significant change in blood cholesterol levels and no new diagnoses of ischaemic heart disease or cerebrovascular accidents among the 69 patients who had switched.

137 patients were receiving the blood pressure drug Iosartan. 26 were excluded by the practice pharmacist or doctors and six patients said they didn’t want to switch. Of the 115 who switched to candesartan, 108 (94 per cent) stayed on the drug.

The reasons for switching back to the original blood pressure drug ranged from one case of chest tightness to patients requesting a change or feeling anxious about their treatment.

At the ten-month review, no patients had suffered adverse events related to the switch.

The authors have stressed the importance of carefully selecting patients based on sound clinical criteria and making sure that patients are happy with the switch and understand the reasons behind it.

“Indiscriminate switching policies in patients previously well controlled may have inherent risks to those patients, either as a direct result of the medication change or indirectly if the change subsequently affects their relationship with medical services or compliance” adds Juliet Usher-Smith.

“This clearly didn’t happen in this study, where patients were carefully selected and, with the exception of a few on blood pressure medication, were happy with the change. “

No adverse events were attributed to the change in medication and the net savings to the practice were significant.

By switching the medication of 185 patients, the practice saved £26,000 - just under two per cent of its annual £1.3 million drugs budget for more than 9,000 registered patients.

The savings were calculated by factoring in staff time and administration as well as drug costs.

The January issue of IJCP also includes two editorials on the paper.

“No healthcare system can afford to countenance the haemorrhaging of public funds on this scale” says Dr Rubin Minhas, a family doctor from Kent, who points out that the UK’s National Health Service is facing one of the biggest overspends in its history.

“Our predicament is shared by the United States where the addition of prescription drugs to the Medicare scheme means that taxpayers, insurers and Medicare beneficiaries could save $8.2 billion in 2007 alone if there were a move to shift statin prescribing to the lower cost generic statins.”

“The authors should be congratulated on their study, which serves as a beacon for the NHS and the wider medical community” adds Dr James Moon from the Heart Hospital, part of University College London Hospital, and Dr Richard Bogle from Experimental Medicine and Toxicology at Imperial College London.

They point out that we live in a world where “financial targets drive change” but that, in this study, the decision to switch to lower cost statins was underpinned by rational and clinically defensible evidence.

Annette Whibley | alfa
Further information:
http://www.ijcp.org

More articles from Health and Medicine:

nachricht World first: Massive thrombosis removed during early pregnancy
20.07.2017 | Universitätsspital Bern

nachricht Therapy of preterm birth in sight?
19.07.2017 | Universitätsspital Bern

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Manipulating Electron Spins Without Loss of Information

Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.

For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...

Im Focus: The proton precisely weighted

What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.

To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...

Im Focus: On the way to a biological alternative

A bacterial enzyme enables reactions that open up alternatives to key industrial chemical processes

The research team of Prof. Dr. Oliver Einsle at the University of Freiburg's Institute of Biochemistry has long been exploring the functioning of nitrogenase....

Im Focus: The 1 trillion tonne iceberg

Larsen C Ice Shelf rift finally breaks through

A one trillion tonne iceberg - one of the biggest ever recorded -- has calved away from the Larsen C Ice Shelf in Antarctica, after a rift in the ice,...

Im Focus: Laser-cooled ions contribute to better understanding of friction

Physics supports biology: Researchers from PTB have developed a model system to investigate friction phenomena with atomic precision

Friction: what you want from car brakes, otherwise rather a nuisance. In any case, it is useful to know as precisely as possible how friction phenomena arise –...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

»We are bringing Additive Manufacturing to SMEs«

19.07.2017 | Event News

The technology with a feel for feelings

12.07.2017 | Event News

Leipzig HTP-Forum discusses "hydrothermal processes" as a key technology for a biobased economy

12.07.2017 | Event News

 
Latest News

Researchers create new technique for manipulating polarization of terahertz radiation

20.07.2017 | Information Technology

High-tech sensing illuminates concrete stress testing

20.07.2017 | Materials Sciences

First direct observation and measurement of ultra-fast moving vortices in superconductors

20.07.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>