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Selective prescribing of simvastatin and atorvastatin by patient characteristics at treatment initiation over a 7-year period in Finland

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Purpose

The aim of the study was to investigate preferential initiation with the two most frequently used statins, simvastatin and atorvastatin, by patient characteristics over time.

Methods

Statin initiators without a statin prescription during the 365 days preceding the initiation from 1 January 1998 through 31 December 2004 were captured from the nation-wide Prescription Register in Finland. Associations of demographic factors and morbidities with atorvastatin versus simvastatin at initiation of statin treatment were analysed by a logistic regression model adjusted for significant covariates separately for each year.

Results

Of all new statin users in 1998, atorvastatin was chosen for 18% and simvastatin for 39%. In 2004, the corresponding figures were 32 and 38%. Atorvastatin was more likely than simvastatin to be initiated in younger age groups than in persons older than 74 years (reference group). Initiation with atorvastatin was less likely for people with than without coronary artery disease; adjusted odds ratios ranged from 0.62 to 0.73 over the years 1998–2003.

Conclusion

Channelling of atorvastatin over simvastatin toward the younger and healthier population was found during the first 4 years after its launch in Finland. Channelling may lead to confounding by indication, which must be taken into account when designing pharmacoepidemiology studies on statins.

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Funding

This study was funded by grant 10/26/2007 from the Social Insurance Institution of Finland (SII).

Role of the funding source

The SII had no role in the design, analyses, interpretation of data, writing the report, or in the decision to submit the manuscript.

Conflict of interests

Arja Helin-Salmivaara: No conflict of interests.

Heli Halava: No conflict of interests.

Jouni Junnila: No conflict of interests.

Risto Huupponen: No conflict of interests.

Author information

Authors and Affiliations

  1. Dept. of Pharmacology, Drug Development and Therapeutics, University of Turku, FI-20014, Turku, Finland

    Heli Halava, Arja Helin-Salmivaara & Risto Huupponen

  2. Dept. of Statistics, University of Turku, Turku, Finland

    Jouni Junnila

  3. Tykslab, Health Care District of Southwest Finland, Turku, Finland

    Risto Huupponen

Authors
  1. Heli Halava
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  2. Arja Helin-Salmivaara
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  3. Jouni Junnila
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  4. Risto Huupponen
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Corresponding author

Correspondence to Arja Helin-Salmivaara.

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Halava, H., Helin-Salmivaara, A., Junnila, J. et al. Selective prescribing of simvastatin and atorvastatin by patient characteristics at treatment initiation over a 7-year period in Finland. Eur J Clin Pharmacol 65, 927–933 (2009). https://doi.org/10.1007/s00228-009-0664-1

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  • DOI: https://doi.org/10.1007/s00228-009-0664-1

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