Quality of Statins Prescription among Patients Admitted at a Tertiary Hospital in south western Nigeria: focus on cost containment
Background: Cost-effective statin prescription should be encouraged especially in resource-limited setting to reduce health expenditure
Aims: The aim of the study was to assess the patterns of statin prescription and cost implication in a resource-limited setting.
Material and methods: Consecutive patients admitted into the six medical wards of the hospital were studied. Information on demographics, number and type and dose of statin prescribed was collected. Cost of statin prescription was calculated for each patient.
Results: Out of 1280 prescriptions encountered, a statin was prescribed in 59 (4.6%). The mean age was 61 years with 64% male and 36% female. A total of 62 statins were prescribed with two prescriptions containing two and three statins each. The generic prescription was low, only 18 (29%) statins were prescribed by generic name, Atorvastatin (67.8%; generic 9.7% and originator 58.1%) was the most prescribed. Average cost per month of statin was₦3 273 ($17). Potential saving from 100% generic prescription of was as much as 98%.The number of daily defined dose (DDD) per 100 patient days was 6.36 DDD. Underdosing continues to be a concern, 83% of prescribed daily doses were less than DDD.
Conclusions: A shift towards better cost-containing statin prescription is advocated. Interventions to encourage generic prescribing and improve dosing need to be implemented.
2. Akunne OO, Godman B, Adedapo AD, Truter I, Fadare J (2016). Statin prescribing among hypertensive patients in south-west Nigeria: findings and implications for the future. J Comp Eff Res.5:281-8
3. Bennie M, Godman B, Bishop I, Campbell S (2012). Multiple initiatives continue to enhance the prescribing efficiency for the proton pump inhibitors and statins in Scotland. Expert Rev Pharmacoecon Outcomes Res. 12:125-30
4. Briasoulis A, Agarwal V, Valachis A, Messerli FH (2013). Antihypertensive Effects of Statins: A Meta-Analysis of Prospective Controlled Studies. JCH.15:310-20
5. Donohue JM, Fischer MA, Huskamp HA, Weissman JS (2008). Potential Savings from an Evidence-Based Consumer-Oriented Public Education Campaign on Prescription Drugs. Health Services Research.43:1557–75.
6. Fadare JO, Adeoti AO, Desalu OO, Enwere OO, Maku AA, Ogunleye O, Sunmonu TA, Truter I, Akunne OO and Godman B (2015). The prescribing of generic medicines in Nigeria: knowledge, perceptions and attitudes of physicians. Expert Rev Pharmacoecon Outcomes Res. 28:1-12
7. Federal Ministry of Health, Nigeria and World Health Organization (WHO) (2005). National Drug Policy- Nigeria. FMOH, WHO. 11-17
8. Fleetcroft R., Schofield P, Ashworth M (2014). Variations in statin prescribing for primary cardiovascular disease prevention: cross-sectional analysis. BMC Health Services Research. doi.org/10.1186/1472-6963-14-414
9. Godman B, Bishop I, Campbell SM, Malmstrom RE, Truter I (2015). Quality and efficiency of statin prescribing across countries with a special focus on South Africa; findings and future implications. Expert Rev. Pharmacoecon Outcomes Res. 15:323–30
10. Godman B, Schwabe U, Selke G, Wettermark B (2009). Update of Recent Reforms in Germany to Enhance the Quality and Efficiency of Prescribing of Proton Pump Inhibitors and Lipid-Lowering Drugs. PharmacoEconomics. 27:435-38
11. Hartz I, Sakshaug S, Furu K, Engeland A, Eggen AE, Njølstad I, Skurtveit S (2007). Aspects of statin prescribing in Norwegian counties with high, average and low statin consumption – an individual-level prescription database study. BMC Clinical Pharmacology. 7:14
12. Koh KK, Quon MJ, Waclawiw MA (2008). Are statins effective for simultaneously treating dyslipidemias and hypertension? Atherosclerosis.196:1-8.
13. Weng TC, Kao Yang YH, Lin SJ, Tai SH (2010). A systematic review and meta-analysis on the therapeutic equivalence of statins. Journal of Clinical Pharmacy and Therapeutics. 35:139–151
14. WHO. Introduction to Drug Utilization Research (2003). WHO International Working Group for Drug Statistics Methodology, WHO Collaborating Centre for Drug Statistics Methodology, WHO Collaborating Centre for Drug Utilization Research and Clinical Pharmacological Services. ISBN 92 4 156234 X (NLM classification: WB 330).
15. Woerkom M, Piepenbrink H, Godman B, et al (2012). Ongoing measures to enhance the efficiency of prescribing of proton pump inhibitors and statins in The Netherlands: influence and future implications. J Comp Eff Res.1:527-38
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