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Purpose: To evaluate the impact of the Food and Drug Administration (FDA) Safety Alert (June 2011) and National Heart Centre Singapore (NHCS) Pharmacy and Therapeutics (P&T) Committee Alert (September 2011) on prescribing patterns of simvastatin (70mg < X ≤ 80mg) and atorvastatin (30mg <Y ≤ 40mg) as an alternate therapy in NHCS.
Methods: This is a retrospective observational study. The number of outpatient pharmacy prescriptions in the year 2011 with simvastatin and atorvastatin in the respective dosing range, was retrieved from the Enterprise Crystal Report Server of NHCS and tabulated in month. The prescribing trends were then compared before and after June and September.
Results: There was a relative reduction of 30.0% for number of patients dispensed with simvastatin from June onwards; the average percentage of prescriptions with simvastatin filled reduced from 1.9% from January to May, to 0.8% from June onwards. However, the number of prescriptions processed for atorvastatin started to pick up in July with an average percentage of 22.9% versus 17.9% previously.
| Year 2011 | Proportion of prescriptions dispensed (Percentage) | |
| 70mg < X ≤ 80mg | 30mg < Y ≤ 40mg | |
| January | 66/3256 (2.0) | 116/695 (16.7) |
| February | 54/2581 (2.1) | 91/554 (16.4) |
| March | 59/3308 (1.8) | 134/708 (18.9) |
| April | 43/2552 (1.7) | 101/580 (17.4) |
| May | 58/2860 (2.0) | 120/629 (19.1) |
| June | 39/2799 (1.4) | 140/735 (19.0) |
| July | 21/2736 (0.8) | 155/748 (20.7) |
| August | 29/3036 (1.0) | 182/777 (23.4) |
| September | 20/2951 (0.7) | 189/795 (23.8) |
| October | 16/2717 (0.6) | 191/792 (24.1) |
| November | 15/2612 (0.6) | 196/908 (21.6) |
| December | 11/2753 (0.4) | 178/747 (23.8) |
Conclusion: The results reflected a reduction in prescriptions for simvastatin with a corresponding increase for atorvastatin, the most cost-effective alternative in the formulary. This study showed that the physicians were keeping abreast with relevant updates that affect patient care in statin therapy.