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Implement Sci. 2017 Nov 25;12(1):141. doi: 10.1186/s13012-017-0671-z.

The impact of a physician detailing and sampling program for generic atorvastatin: an interrupted time series analysis.

Author information

1
Centre for Health Services and Policy Research, School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada. heather.worthington@ubc.ca.
2
, 201-2206 East Mall, Vancouver, BC, V6T 1Z3, Canada. heather.worthington@ubc.ca.
3
Centre for Health Services and Policy Research, School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
4
Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
5
School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
6
Manitoba Centre for Health Policy, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
7
Department of Population Medicine, Harvard Medical School, Boston, MA, USA.

Abstract

BACKGROUND:

In 2011, Manitoba implemented a province-wide program of physician detailing and free sampling for generic atorvastatin to increase use of this generic statin. We examined the impact of this unique combined program of detailing and sampling for generic atorvastatin on the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin.

METHODS:

We conducted a retrospective study of Manitoba insurance claims data for all continuously enrolled patients who filled one or more prescriptions for a statin between 2008 and 2013. Data were linked to physician-level data on the number of detailing visits and sample provision. We used interrupted time series analyses to assess policy-related changes in the use and cost of statin medicines, market share of generic atorvastatin, the choice of starting statin for new users, and switching from a branded statin to generic atorvastatin.

RESULTS:

The detailing program reached 31% (651/2103) of physicians who prescribed a statin during the study period. Collectively, these physicians prescribed 61% of statins dispensed in the province. Free sample cards were provided to 61% (394/651) of the detailed physicians. The program did not change the level or trend in the overall statin use rate and the total cost of statins or increase the number of patients switching from another branded statin to generic atorvastatin. We found the program had a small impact on atorvastatin's market share of new prescriptions, with a level increase of 2.6%.

CONCLUSIONS:

Though physician detailers were skilled at targeting high-prescribing physicians, a combined program of detailing visits and sample provision for generic atorvastatin did not lower overall statin costs or lead to switching from branded statins to the generic. The preceding introduction of generic atorvastatin appeared sufficient to modify prescribing patterns and decrease costs.

KEYWORDS:

Atorvastatin; Detailing; Generic drugs; Sampling

PMID:
29178960
PMCID:
PMC5702229
DOI:
10.1186/s13012-017-0671-z
[Indexed for MEDLINE]
Free PMC Article

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