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Generic Statins:1, Branded Statins: 0

Posted Feb 20 2013 3:00am
Go look in your medicine cabinet.  There's a good chance that you've got a statin or cholesterol lowering medication buried in there among your Propecia & Viagra.  The big question is whether you're taking a generic or branded statin.  We've known for a while now that generic statins are generally just as good as their branded predecessors.  And yet, we continue to prescribe name brand statins which are more expensive w/o any improvement in outcome benefits.  Which begs the question why?

I suppose there are a few of us who can't lower our LDL enough with the highest dose of atorvastatin.  But let's be clear that that's the generic atorvastatin rather than the branded Lipitor which has no raison d'etre.  In this small fraction of the population, I could see a case being made for high dose Crestor (not yet available as generic rosuvastatin).  However, I'd also want to warn my patient that we're trading proven outcome benefits (lowering risk of cardiovascular events) for proven LDL lowering.

In fact, a review editorial was published last week in JAMA Internal Medicine in which the authors were even more hard line and found no reason whatsoever for prescribing the two newest brand only statins.  I suppose if the copay is the same to you regardless of which statin was prescribed, you might not care.  But remember that any expenses are traced back to corporate headquarters such that your insurance rate may be going up next year.  So perhaps it's not really free after all.

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