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dc.contributor.authorGagne, Joshua J
dc.contributor.authorChoudhry, Niteesh Kumar
dc.contributor.authorKesselheim, Aaron Seth
dc.contributor.authorPolinski, Jennifer Milan
dc.contributor.authorHutchins, David
dc.contributor.authorMatlin, Olga S.
dc.contributor.authorBrennan, Troyen Anthony
dc.contributor.authorAvorn, Jerry Lewis
dc.contributor.authorShrank, William
dc.date.accessioned2017-07-07T19:30:24Z
dc.date.issued2014
dc.identifier.citationGagne, Joshua J., Niteesh K. Choudhry, Aaron S. Kesselheim, Jennifer M. Polinski, David Hutchins, Olga S. Matlin, Troyen A. Brennan, Jerry Avorn, and William H. Shrank. 2014. “Comparative Effectiveness of Generic and Brand-Name Statins on Patient Outcomes.” Annals of Internal Medicine 161 (6) (September 16): 400. doi:10.7326/m13-2942.en_US
dc.identifier.issn0003-4819en_US
dc.identifier.issn1539-3704en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:33177339
dc.description.abstractBackground: Statins are effective in preventing cardiovascular events, but patients do not fully adhere to them. Objective: To determine whether patients are more adherent to generic statins versus brand-name statins (lovastatin, pravastatin, or simvastatin) and whether greater adherence improves health outcomes. Design: Observational, propensity score–matched, new-user cohort study. Setting: Linked electronic data from medical and pharmacy claims. Participants: Medicare beneficiaries aged 65 years or older with prescription drug coverage between 2006 and 2008. Intervention: Initiation of a generic or brand-name statin. Measurements: Adherence to statin therapy (measured as the proportion of days covered [PDC] up to 1 year) and a composite outcome comprising hospitalization for an acute coronary syndrome or stroke and all-cause mortality. Hazard ratios (HRs) and absolute rate differences were estimated. Results: A total of 90 111 patients who initiated a statin during the study was identified; 83 731 (93%) initiated a generic drug, and 6380 (7%) initiated a brand-name drug. The mean age of patients was 75.6 years, and most (61%) were female. The average PDC was 77% for patients in the generic group and 71% for those in the brand-name group (P < 0.001). An 8% reduction in the rate of the clinical outcome was observed among patients in the generic group versus those in the brand-name group (HR, 0.92 [95% CI, 0.86 to 0.99]). The absolute difference was −1.53 events per 100 person-years (CI, −2.69 to −0.19 events per 100 person-years). Limitation: Results may not be generalizable to other populations with different incomes or drug benefit structures. Conclusion: Compared with those initiating brand-name statins, patients initiating generic statins were more likely to adhere and had a lower rate of a composite clinical outcome. Primary Funding Source: Teva Pharmaceuticals.en_US
dc.description.sponsorshipAfrican and African American Studiesen_US
dc.language.isoen_USen_US
dc.publisherAmerican College of Physiciansen_US
dc.relation.isversionofdoi:10.7326/M13-2942en_US
dc.relation.hasversionhttp://scholar.harvard.edu/files/nkc/files/2014_comparative_effectiveness_of_brand_and_generic_statins_annals.pdfen_US
dash.licenseMETA_ONLY
dc.subjectmyocardial infarctionen_US
dc.subjecthypercholesterolemiaen_US
dc.subjectstatinsen_US
dc.subjectantilipemic agentsen_US
dc.subjectcerebrovascular accidenten_US
dc.subjectischemic strokeen_US
dc.subjectdrug costsen_US
dc.subjectgeneric drugsen_US
dc.subjectmedication adherenceen_US
dc.subjectpatient-focused outcomesen_US
dc.titleComparative Effectiveness of Generic and Brand-Name Statins on Patient Outcomesen_US
dc.typeJournal Articleen_US
dc.date.updated2014-09-22T13:46:12Z
dc.description.versionVersion of Recorden_US
dc.relation.journalAnnals of Internal Medicineen_US
dash.depositing.authorKesselheim, Aaron Seth
dash.embargo.until10000-01-01
dc.identifier.doi10.7326/M13-2942*
workflow.legacycommentsauth.collection Kesselheim emailed 2017-03-25 MM meta.darken_US
dash.contributor.affiliatedBrennan, Troyen
dash.contributor.affiliatedShrank, William
dash.contributor.affiliatedPolinski, Jennifer Milan
dash.contributor.affiliatedGagne, Joshua
dash.contributor.affiliatedChoudhry, Niteesh
dash.contributor.affiliatedAvorn, Jerome
dash.contributor.affiliatedKesselheim, Aaron


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