Quality of Statins Prescription in Patients Admitted at a Tertiary Hospital in Southwestern Nigeria: Focus on Cost Containment

Abstract

Cost-effective statin prescription should be encouraged especially in  resource-limited setting to reduce health expenditure. The aim of the study was to assess the patterns of statin prescription and cost implication in a resource-limited setting. 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. 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 was as much as 98%. The number of daily defined dose (DDD) per 100 patient days was 6.36 DDD. Under-dosing continues to be a concern, 83% of prescribed daily doses were less than DDD. A shift towards better cost-containing statin prescription is advocated. Interventions to encourage generic prescribing and improve dosing need to be implemented.

Keywords: Cost, prescribing pattern, DDD, Statin, Generics