Comparison of treatment patterns, efficacy and safety between generic and branded atorvastatin users in China: a multicenter, retrospective propensity score-matched cohort study

Abstract Background To evaluate and compare the treatment patterns, effectiveness, and safety of generic and branded atorvastatin in China. Methods This multicenter, retrospective cohort study collected and analyzed data from patients who initiated atorvastatin therapy for the first time across 16 h...

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Main Authors: Xiaoxuan Xing, Zhizhou Wang, Ke Wang, Yiming Hua, Xiaoxi Li, Kejia Le, Wenbing Ma, Yingyun Guan, Aiping Deng, Xiong Yun, Hongfu Cai, Yongning Lyu, Guoying Xiong, Min Yang, Siyang Wang, Chaojun Xue, Jing Zhang, Qiushi Guo, Song Hu, Jing Li, Xianzhe Dong, Lan Zhang
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Lipids in Health and Disease
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Online Access:https://doi.org/10.1186/s12944-025-02673-9
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author Xiaoxuan Xing
Zhizhou Wang
Ke Wang
Yiming Hua
Xiaoxi Li
Kejia Le
Wenbing Ma
Yingyun Guan
Aiping Deng
Xiong Yun
Hongfu Cai
Yongning Lyu
Guoying Xiong
Min Yang
Siyang Wang
Chaojun Xue
Jing Zhang
Qiushi Guo
Song Hu
Jing Li
Xianzhe Dong
Lan Zhang
author_facet Xiaoxuan Xing
Zhizhou Wang
Ke Wang
Yiming Hua
Xiaoxi Li
Kejia Le
Wenbing Ma
Yingyun Guan
Aiping Deng
Xiong Yun
Hongfu Cai
Yongning Lyu
Guoying Xiong
Min Yang
Siyang Wang
Chaojun Xue
Jing Zhang
Qiushi Guo
Song Hu
Jing Li
Xianzhe Dong
Lan Zhang
author_sort Xiaoxuan Xing
collection DOAJ
description Abstract Background To evaluate and compare the treatment patterns, effectiveness, and safety of generic and branded atorvastatin in China. Methods This multicenter, retrospective cohort study collected and analyzed data from patients who initiated atorvastatin therapy for the first time across 16 hospitals between 2020 and 2022. Treatment patterns included adherence, persistence, switching, augmentation. Absolute reductions of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol, total cholesterol, and triglycerides, LDL-C reduction ≥ 50%, and adverse events were assessed to measure efficacy and safety. Propensity score matching was utilized to control for potential confounding variables. Results Data of 359,159 patients were reviewed. The results indicated a greater proportion of patients the generic atorvastatin group (5772/39742 [14.5%]) exhibited good adherence compared to those in the branded atorvastatin group (3157/39742 [7.9%]; P < 0.001) with an odds ratio of 1.97 (95% CI 1.88–2.06; P < 0.001). In the generic atorvastatin group, a smaller proportion of patients discontinued treatment (35,621/39,742 [89.6%]) compared to the branded group (36,390/39742 [91.6%]; P < 0.001) This difference in treatment persistence was further reflected in the calculated hazard ratio, which was 0.85 (95% CI 0.84–0.86; P < 0.001), indicating a reduced risk of discontinuation in the generic group. Efficacy outcomes were comparable between two groups (all P > 0.05). Both groups exhibited a comparable incidence of most adverse events. Less fasting plasma glucose increase and fewer new-onset diabetes were observed in the generic group (0.01 mmol/L [IQR 0–0.58] vs 0.16 mmol/L [IQR 0–0.73]; P = 0.009; 664/28640 [2.3%] vs 1244/28640 [4.3%]; P < 0.001). Conclusion Generic atorvastatin had higher adherence and persistence and lower costs vs the branded drug, with no significant differences in efficacy and safety. Generic atorvastatin can be considered a viable option for dyslipidemia and atherosclerotic cardiovascular disease.
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series Lipids in Health and Disease
spelling doaj-art-67edc09730bf40548bbcbe047084ea302025-08-20T03:46:29ZengBMCLipids in Health and Disease1476-511X2025-07-012411910.1186/s12944-025-02673-9Comparison of treatment patterns, efficacy and safety between generic and branded atorvastatin users in China: a multicenter, retrospective propensity score-matched cohort studyXiaoxuan Xing0Zhizhou Wang1Ke Wang2Yiming Hua3Xiaoxi Li4Kejia Le5Wenbing Ma6Yingyun Guan7Aiping Deng8Xiong Yun9Hongfu Cai10Yongning Lyu11Guoying Xiong12Min Yang13Siyang Wang14Chaojun Xue15Jing Zhang16Qiushi Guo17Song Hu18Jing Li19Xianzhe Dong20Lan Zhang21Department of Pharmacy, Xuanwu Hospital of Capital Medical UniversityDepartment of Pharmacy, Xuanwu Hospital of Capital Medical UniversityDepartment of Pharmacy, Xuanwu Hospital of Capital Medical UniversityDepartment of Pharmacy, Xuanwu Hospital of Capital Medical UniversityDepartment of Pharmacy, Xuanwu Hospital of Capital Medical UniversityDepartment of Pharmacy, Renji Hospital, Shanghai JiaoTong University School of MedicineDepartment of Pharmacy, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Pharmacy, Ruijin Hospital, Shanghai JiaoTong University School of MedicineDepartment of Pharmacy, The Central Hospital of WuhanDepartment of Pharmacy, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University)Department of Pharmacy, Fujian Medical University Union HospitalDepartment of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and TechnologyDepartment of Pharmacy, Nanchang First HospitalDepartment of Pharmacy, Xi’an Central HospitalDepartment of Pharmacy, The Second Hospital of Shanxi Medical UniversityDepartment of Pharmacy, Hebei General HospitalDepartment of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityPharmacy Department, First Hospital of Jilin University-The Eastern DivisionDepartment of Pharmacy, Wuhan No.1 HospitalDepartment of Pharmacy, The Affiliated Hospital of Qingdao UniversityDepartment of Pharmacy, Xuanwu Hospital of Capital Medical UniversityDepartment of Pharmacy, Xuanwu Hospital of Capital Medical UniversityAbstract Background To evaluate and compare the treatment patterns, effectiveness, and safety of generic and branded atorvastatin in China. Methods This multicenter, retrospective cohort study collected and analyzed data from patients who initiated atorvastatin therapy for the first time across 16 hospitals between 2020 and 2022. Treatment patterns included adherence, persistence, switching, augmentation. Absolute reductions of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol, total cholesterol, and triglycerides, LDL-C reduction ≥ 50%, and adverse events were assessed to measure efficacy and safety. Propensity score matching was utilized to control for potential confounding variables. Results Data of 359,159 patients were reviewed. The results indicated a greater proportion of patients the generic atorvastatin group (5772/39742 [14.5%]) exhibited good adherence compared to those in the branded atorvastatin group (3157/39742 [7.9%]; P < 0.001) with an odds ratio of 1.97 (95% CI 1.88–2.06; P < 0.001). In the generic atorvastatin group, a smaller proportion of patients discontinued treatment (35,621/39,742 [89.6%]) compared to the branded group (36,390/39742 [91.6%]; P < 0.001) This difference in treatment persistence was further reflected in the calculated hazard ratio, which was 0.85 (95% CI 0.84–0.86; P < 0.001), indicating a reduced risk of discontinuation in the generic group. Efficacy outcomes were comparable between two groups (all P > 0.05). Both groups exhibited a comparable incidence of most adverse events. Less fasting plasma glucose increase and fewer new-onset diabetes were observed in the generic group (0.01 mmol/L [IQR 0–0.58] vs 0.16 mmol/L [IQR 0–0.73]; P = 0.009; 664/28640 [2.3%] vs 1244/28640 [4.3%]; P < 0.001). Conclusion Generic atorvastatin had higher adherence and persistence and lower costs vs the branded drug, with no significant differences in efficacy and safety. Generic atorvastatin can be considered a viable option for dyslipidemia and atherosclerotic cardiovascular disease.https://doi.org/10.1186/s12944-025-02673-9AtorvastatinReal-world studyPropensity score matchingTreatment patternsEfficacySafety
spellingShingle Xiaoxuan Xing
Zhizhou Wang
Ke Wang
Yiming Hua
Xiaoxi Li
Kejia Le
Wenbing Ma
Yingyun Guan
Aiping Deng
Xiong Yun
Hongfu Cai
Yongning Lyu
Guoying Xiong
Min Yang
Siyang Wang
Chaojun Xue
Jing Zhang
Qiushi Guo
Song Hu
Jing Li
Xianzhe Dong
Lan Zhang
Comparison of treatment patterns, efficacy and safety between generic and branded atorvastatin users in China: a multicenter, retrospective propensity score-matched cohort study
Lipids in Health and Disease
Atorvastatin
Real-world study
Propensity score matching
Treatment patterns
Efficacy
Safety
title Comparison of treatment patterns, efficacy and safety between generic and branded atorvastatin users in China: a multicenter, retrospective propensity score-matched cohort study
title_full Comparison of treatment patterns, efficacy and safety between generic and branded atorvastatin users in China: a multicenter, retrospective propensity score-matched cohort study
title_fullStr Comparison of treatment patterns, efficacy and safety between generic and branded atorvastatin users in China: a multicenter, retrospective propensity score-matched cohort study
title_full_unstemmed Comparison of treatment patterns, efficacy and safety between generic and branded atorvastatin users in China: a multicenter, retrospective propensity score-matched cohort study
title_short Comparison of treatment patterns, efficacy and safety between generic and branded atorvastatin users in China: a multicenter, retrospective propensity score-matched cohort study
title_sort comparison of treatment patterns efficacy and safety between generic and branded atorvastatin users in china a multicenter retrospective propensity score matched cohort study
topic Atorvastatin
Real-world study
Propensity score matching
Treatment patterns
Efficacy
Safety
url https://doi.org/10.1186/s12944-025-02673-9
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