Ezetimibe with simvastatin utilisation analysis
Page last updated: 6 March 2015
Drug utilisation sub-committee (DUSC)
October 2014
Abstract
Purpose
To compare the predicted versus actual use of ezetimibe with simvastatin (Vytorin®) following the extension to listing from 1 December 2012 for the 10/10 and 10/20 strengths for patients inadequately controlled on the maximum tolerated dose of a statin. The listing was not expected to result in any additional patients being treated as the free combination of ezetimibe and simvastatin 10 mg or 20 mg could be used if this was the maximum tolerated dose of simvastatin. The analysis was undertaken in the context of the complete PBS and RPBS ezetimibe market as patients may move between ezetimibe plain and fixed dose combination (FDC) presentations.
Date of listing on PBS
The extension to the listing of the 10-10 and 10-20 strengths of ezetimibe with simvastatin FDC products was effective from 1 December 2012.
The full PBS listing history of ezetimibe and its combination products is provided in Appendix A.
Data Source / methodology
Prescription data from the Department of Human Services pharmacy claims database and the DUSC database.
Key Findings
- The number of new patients commencing ezetimibe in any presentation is steady, with approximately 38,000 new patients each year. The number of prevalent patients on ezetimibe is increasing over time, and the majority of use is ezetimibe added to a statin.
- The submission assumed that the requested change would not result in any additional patients being treated. Rather, the 10-10 mg and 10-20 mg FDCs were expected to replace the concomitant use of ezetimibe and simvastatin. This has not been the case. Twelve months after the extension to listing:
- the number of patients taking ezetimibe + simvastatin 10 mg or 20 mg (as the concomitant agents or in a fixed dose combination) increased from 9,800 to 12,872; and
- an additional 3,096 people were on the 10-10 and 10-20 FDC forms, but only 24 fewer patients were on the concomitant agents. Therefore the FDC did not substitute for the concomitant agents.
- Analysis of the streamlined authority code data indicates that ezetimibe as add on to a statin, in patients inadequately controlled on the maximum tolerated dose of a statin, is contributing the most to overall use.
Full Report
