gms | German Medical Science

14. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

15.11. - 16.11.2007, Frankfurt am Main

Fixed prices for statins in Germany – effects on prescriptions and clinical consequences

Meeting Abstract

Suche in Medline nach

  • corresponding author K. Bestehorn - MSD SHARP & DOHME GMBH, Haar
  • W. Greiner - Fakultät für Gesundheitswissenschaften, Gesundheitsökonomie und Gesundheitsmanagement (AG5), Bielefeld

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 14. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Frankfurt am Main, 15.-16.11.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. Doc07gaa10

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Veröffentlicht: 12. November 2007

© 2007 Bestehorn et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen ( Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.



Context: Little or no data are currently available in Germany on the effects of different acceptance by the pharmaceutical manufacturers and the implementation of fixed prices for drugs, some of which are still under patent protection.

Aim of the study: We investigated the extent to which patients who were prescribed atorvastatin in the third quarter of 2004 continued to receive lipid-lowering treatment during the first three quarters of 2005 and whether a change in treatment altered their cholesterol levels and risk-factor profile.

Material and method: To prevent any study-related influence on prescribing practice, we conducted a retrospective study that included up to 50 patients from each of 52 GP or internist practices who were prescribed atorvastatin in the third quarter of 2004. Patients’ risk-factor profile, age, sex, BMI, insurance status, blood pressure, prescriptions of lipid-lowering drugs, drug dosage, lipid levels and hospitalization rate up to the end of the third quarter of 2005 were documented.

Results: 1,249 patients (median 65 years, 90.5% in the statutory health insurance system [SHI], 56.5% male) with a mean BMI of 28.07 were enrolled in the study. 72.2% had CHD, diabetes mellitus, or a history of a cerebrovascular event. After the fixed-price regulation came into effect, atorvastatin was replaced in 71.2% by another lipid-lowering agent, in 90.6% of cases by another statin. 15.3% of the patients received an equivalent dose and 44.5% a lower dose of the alternative statin. In 15.3% the lipid-lowering therapy was discontinued. Cholesterol levels remained constant during continuous atorvastatin therapy (LDL cholesterol 115.5 mg/dL, baseline 116.9 mg/dL); within a few weeks of the treatment being changed, 60.5% of the patients experienced a prognostically relevant increase in LDL cholesterol to 124.3 (vs 116.5 mg/dL), and an increase in hospitalizations (p=0.01). The share of patients with LDL cholesterol levels <100 mg/dL fell to 24.6% compared to 34.6% in the group that continued to receive atorvastatin. The key factors influencing a change in treatment were the patients’ insurance status (treatment changed in 76.6% of SHI patients and in 19.8% of privately insured patients) and the number of risk factors (the higher the number of risk factors the lower the change rate).

Conclusion: The introduction of fixed prices for drug groups, which also affect some patent-protected drugs, can lead to considerable changes in prescribing practice with clinically relevant consequences.