Abstract 128: Adherence to Generic vs. Brand Statins among Older Patients After Acute Myocardial Infarction
Background: Statins reduce mortality after acute myocardial infarction (MI), but up to half of patients discontinue statins within 1 year of starting therapy. Cost is one factor that may influence medication adherence, yet it is unknown whether use of generic vs. brand statin influences medication adherence.
Methods: We linked detailed in-hospital clinical data for 1,421 NSTEMI patients discharged on a statin in 2006 to Medicare Part D medication claims records to examine post-discharge medication use. We excluded brand statin fills for which there were no generic dose equivalents. One-year statin adherence was defined as the proportion of days covered (PDC). We examined the association of brand vs. generic statin prescription and one-year adherence after adjusting for demographics, clinical factors, pre-discharge lipid values, prior statin use, and copay amount.
Results: Overall, 65.5% of statin fills were for brand named statins. There were few baseline differences in demographics and clinical factors among generic vs. brand users. Patient copay amounts for generic statins (median=$5; IQR 1 - 10) were lower than those for brand statins (median=25; IQR 3 - 35). The mean PDC over one year was similar for brand users (71.5%; SD 31.2) and generic users (68.9%; STD 35.2%; p=0.97; unadjusted OR 1.15 [95% CI 0.96, 1.37]). Adherence remained non-significantly different between generic and brand statin users after adjusting for demographics, clinical risk factors, lipid value, prior statin use, and copay amount (Figure). Copay amount was not significantly associated with PDC (Per $ increase: OR=0.99 [95% CI 0.97, 1.01]; p=0.23).
Conclusions: In a cohort of older NSTEMI patients, we found no evidence that adherence to statins one year after hospital discharge was improved among patients prescribed generic statins vs. brand statins.
Author Disclosures: E.C. O'Brien: None. E.D. Peterson: B. Research Grant; Modest; Society of Thoracic Surgeons, American College of Cardiology, Eli Lilly & Company, American Heart Association, Janssen Pharmaceutical Products. G. Consultant/Advisory Board; Modest; Boehringer Ingelheim, Genentech, Eli Lilly & Company, Janssen Pharmaceutical Products, Merck & Co., Sanofi-Aventis. L.A. McCoy: None. L. Thomas: None. T.Y. Wang: B. Research Grant; Modest; Lilly USA, Daiichi Sankyo, Gilead Science, GlaxoSmithKline, American College of Cardiology, American Society of Nuclear Cardiology. G. Consultant/Advisory Board; Modest; AstraZeneca, American College of Cardiology Foundation.
- © 2014 by American Heart Association, Inc.