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Lipid‐Lowering Efficacy, Safety, and Costs of a Large‐Scale Therapeutic Statin Formulary Conversion Program
Author(s) -
Taylor Allen J.,
Grace Karen,
Swiecki Jennifer,
Hyatt Richard,
Gibbs Henry,
Sheikh Munazza,
O'Malley Patrick G.,
Lowenthal Susan Pitman,
West Mark,
Spain John,
Maneval Kent,
Jones David L.
Publication year - 2001
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.21.13.1130.34616
Subject(s) - formulary , medicine , adverse effect , observational study , statin , simvastatin , national cholesterol education program , cerivastatin , cholesterol , physical therapy , emergency medicine , pharmacology , pravastatin , obesity , metabolic syndrome
Study Objective. To assess the lipid‐lowering efficacy, safety, and costs of a large‐scale statin formulary conversion program. Design. Prospective, observational study. Setting. Tertiary academic medical center. Patients. A total of 980 patients consented to participate; 942 patients completed the study. Intervention. Patients were converted from their current statin therapy to either cerivastatin 0.4 or 0.8 mg/day, or simvastatin 80 mg/day, using a conversion algorithm. Measurements and Main Results. Efficacy and safety were evaluated at baseline and after 6 weeks of therapy; costs were also measured. Overall attainment of the National Cholesterol Education Program (NCEP) goal for low‐density lipoprotein cholesterol (LDL) increased from 64.8% to 74.5% of patients (p<0.001); mean LDL decreased from 115 ± 30 mg/dl to 106 ± 25 mg/dl (p<0.001). Adverse events occurred in 3% of patients, and included myositis (0.6%) and increased hepatic transaminases (0.1%). Overall costs were reduced by $115/patient treatment‐year. Conclusion. Statin therapeutic interchange can improve lipid control at reduced costs. The possibility of uncommon but potentially serious adverse effects suggests that these programs require appropriate monitoring.