Brand-Name Statin Use Tied to High Cost of Unneeded Care

(FDA.gov)

Researchers from medical centers in New York and San Francisco found that nearly 87 percent of the estimated $6.7 billion spent in one year on unnecessary tests or medications in primary care, is consumed by brand-name statins to treat high cholesterol. The findings appear in a research letter in the 1 October online issue of the journal Archives of Internal Medicine.

The team led by Mount Sinai School of Medicine postdoctoral fellow Minal Kale reviewed a May 2011 study that identified the top five most overused clinical activities in each of three primary care specialties: pediatrics, internal medicine, and family medicine. They then analyzed separate data from the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. These surveys collect data on patient visits to physicians in non–federally funded, non–hospital-based offices and non–federally funded hospital outpatient departments, respectively.

The researchers — including analysts from Mount Sinai School of Medicine and Weill Cornell Medical College in New York, University of California in San Francisco, and San Francisco Veterans Affairs Hospital — calculated each activity as the proportion of eligible visits during which the patient received non-recommended care. They estimated the costs of procedures using the 2011 Medicare physician fee schedule, and in the case of laboratory tests, the 2011 Medicare Clinical Laboratory Fee Schedule. Costs of drugs were calculated from prices at the Web site drugstore.com and at retail pharmacies.

The results show more than $6.7 billion was spent in excess health care spending in primary care in 2009. Of that $6.7 billion, more than $5.8 billion — nearly 87 percent of the total — resulted from the prescribing of brand-name statins rather than generic versions. Unnecessary bone density scans in younger women accounted for another $527 million, almost 8 percent.

Other costs revealed by the analysis include …

– CT scans, MRIs, or X-rays in people presenting with back pain accounted for $175 million.

– Over-prescription of antibiotics for sore throat in children, excluding cases of strep throat or fever, accounted for $116 million.

– During physical exams, more than half of complete blood work ordered was not needed, resulting in more than $32 million.

– Other excess costs included needless annual echocardiograms, urine testing, pap tests, and pediatric cough medicine prescriptions totaled about $50 million.

Unneeded Health Care Costs

The authors point out that they were conservative in their assessments of inappropriate care and careful to exclude visits where care could be potentially appropriate, likely lowering their cost estimates.

Read more: Generic Drugs Can Generate Sharp Health Care Cost Reductions

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