REPLACING LOVASTATIN WITH PRAVASTATIN - EFFECT ON SERUM-LIPIDS AND COSTS

The effects on costs and lipid levels of replacing lovastatin therapy with pravastatin were studied. Beginning in April 1992, outpatients re ceiving lovastatin were switched to pravastatin. Physicians were asked but not required to initiate the pravastatin sodium treatment at half the daily lovastatin dose in milligrams. In October 1993, the dosages of lovastatin and pravastatin and the corresponding lipid-profile res ults were recorded for each patient for whom lovastatin had been repla ced by pravastatin. The drug acquisition cost per year of therapy was calculated for each patient's most recent dosage of lovastatin and pra vastatin as of April 1993. The costs used in the analysis were the mos t recent available (March 1995). Lovastatin therapy was changed to pra vastatin in a total of 168 patients. Of the 168 patients, 145 (86%) we re prescribed an initial daily pravastatin sodium dose that was at lea st 50% lower in milligrams than that of lovastatin. All of the 168 pat ients who received pravastatin had two usable total-cholesterol measur ements during lovastatin therapy, and 148 (88%) had at least one such measurement during pravastatin therapy. Among patients with usable ser um-lipid data, there was no significant difference between any of the mean serum lipid concentrations (total cholesterol, low-density-lipopr otein cholesterol, or high-density-lipoprotein cholesterol) before and after the conversion. The annual cost of lovastatin for the 148 patie nts would be $71,693 for the most recent dosages; the corresponding co st for pravastatin would be $56,875 (21% lower). The replacement of lo vastatin with pravastatin sodium was associated with a 21% cost reduct ion but no significant change in mean serum lipid concentrations.