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Prescriptions for most popular statins on the rise
Data shows the number of people using the most popular statins is increasing, while the cost for COVID-19 antivirals has fallen.
Statins have been among the most prescribed drugs for a number of years now.
More people are taking the most popular statin drugs than ever, according to annual figures published in Australian Prescriber.
Rosuvastatin and atorvastatin headed the top 10 list of the most prescribed drugs from 1 July 2023 to 30 June 2024 under the Pharmaceutical Benefits Schedule (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS).
More than 80 people per 1000 are taking a standard dose of the drugs every day, both of which have registered significant leaps over the past five years. In the past year, they also had the highest prescription counts overall with rosuvastatin registering the most at more than 17 million.
Australian Prescriber says the defined daily dose (DDD) metric per 1000 people is ‘a more useful measure of drug utilisation than prescription counts as it ‘shows how many people in every thousand Australians are taking the standard dose of a drug every day’.
While there were shifts in prescription rates, the drugs on the list remained unchanged compared to 2022–23, with the list dominated by treatments for high-cholesterol and heart disease, alongside two antidepressants, sertraline and escitalopram.
Dr Michael Tam, who sits on the RACGP Expert Committee – Quality Care, noted that the statin medications have been a regular feature of the lists for a number of years.
‘That’s been the case for ages and largely represents the community prevalence of chronic disease,’ he told newsGP.
‘With the population gradually getting older, there’s a lot of risk for cardiovascular disease, that, for the most part, is what that represents.’
While there are no broad-spectrum antibiotics in the top 10 list, Dr Tam suggested there is no reason for complacency surrounding antimicrobial stewardship.
‘In a very blunt way, I suppose that’s good,’ he said. ‘The total volume depends on everything else that’s there – there are very large variations across the country, different regions, different populations.’
He said from a quality care perspective, the statistics also do not indicate whether the prescriptions are appropriate.
‘Sometimes people who may have very limited benefit end up being prescribed medication,’ Dr Tam said.
‘Similarly, the other way around – people who would definitely benefit being on the medication for some reason are not.’
The most costly drug to the Federal Government in the timeframe was pembrolizumab, an immunotherapy cancer treatment drug which was prescribed 68,148 times at a cost of $580 million, not including rebates.
That is a change from last year, when the COVID-19 antiviral molnupiravir topped the list of most expensive. In 2022–23 the combined cost of that antiviral alongside nirmatrelvir with ritonavir came to more than $1 billion.
For Dr Tam, the spending raises broader questions about how money is targeted, noting the low number of prescriptions for some of the most expensive drugs.
‘Smoking, alcohol and obesity are major drivers for cancers,’ he said.
‘One would wonder what would happen if we invested anywhere close to the total annual funding to some of these novel and newer anti-cancer drugs towards more preventive approaches.
‘We won’t see those benefits right away, but in the longer term, we may actually prevent way more cancers and that benefit will accrue to a much larger population.’
The list of prescriptions is taken from data provided by the Department of Health and Aged Care, from 1 July 2023 to 30 June 2024. The figures are based on prescriptions from the date of supply.
Top 10 PBS/RPBS drugs by DDD/1000 pop/day:
Rosuvastatin: 84.59
Atorvastatin: 80.72
Amlodipine: 54.08
Perindopril: 53.65
Candesartan: 35.02
Telmisartan: 34.10
Sertraline: 30.64
Escitalopram: 28.65
Metformin: 28.32
Irbesartan: 25.33
Top 10 PBS and RPBS drugs by cost to government (not including rebates)
Pembrolizumab: $580,519,979 (68,148 prescriptions)
Elexacaftor+tezacaftor+ivacaftor with ivacaftor: $568,739,037 (26,609)
Nivolumab: $449,363,401 (62,276)
Ustekinumab: $438,267,241 (60,496)
Molnupiravir: $430,190,110 (371,952)
Aflibercept: $427,003,953 (436,779)
Dupilumab: $368,349,053 (214,577)
Apixaban: $346,176,827 (4,157,993)
Nirmatrelvir with ritonavir: $325,856,114 (270,376)
Denosumab: $297,539,759 (1,178,731)
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