Criteria for the appropriate statin cited

Doctors have always been quick to prescribe statins to their patients with lipid abnormalities. A medicine which is known to significantly lower cholesterol level, statin has gained its place in the doctors‚ therapeutic armamentarium for the treatment of cholesterol and lowering the risk of cardiovascular complications such as heart attacks or strokes.

With its efficacy established, the market has been flooded with several brands of statins. A dilemma, however, arose since doctors and patients get more confused which brand to prescribe and take.

According to Dr. Eugene Ramos, a noted heart specialist who is also a member of the board of trustees of the Philippine College of Physicians, the ideal statin should be effective in lowering the bad cholesterol (low density lipoprotein), triglycerides and elevating the good cholesterol (high density lipoprotein).

He also said that a statin should have supporting clinical trials which will prove its efficacy in reducing the risk of cardiovascular death and morbidity.

Ramos advised that a hypercholesterolemic patient looking for a good statin should look for a high-quality brand.

In addition, he said patients should also consider the company that is manufacturing or selling it. "The quality of the product and integrity of the company are paramount," he said.

Since it should be taken religiously for at least three to five years, Ramos puts equal importance to cost in prescribing the appropriate brand of statin.

"It should also be affordable for chronic use so that my patients can take them for life, if need be, without undue financial burden," he said.

In the Philippines, the cost of drugs is one of the common barriers of long-term statin therapy. This is made worse by the fact that most Filipinos are not well-informed about the possible complications of not adhering to their medication.

"In a way, Filipinos do not really have a choice. Even if they are well-informed the need for statin therapy is far less important than the need for food on the table," Ramos said.

From the business standpoint, another barrier to statin therapy, Ramos claimed, is the multinational companies’ professed desire to alleviate the health of the Filipinos and their focus on profit.

Before the introduction of an affordable brand of simvastatin by a local pharmaceutical company, 40 mg of statin costs more than P80. Taken once a day, statin therapy usually takes a sizable part of the family’s budget, especially if the family is an average earner.

Ramos is one of many doctors who welcomed the introduction of an affordable and bioequivalent brand of simvastatin. With the same efficacy at a price which is almost 50 percent less than the innovator brand, doctors and patients now have an alternative drug which can effectively lower cholesterol level.

Simvastatin, which has been shown to be effective in preventing heart attack and stroke, is a prescription product and should be taken only upon the advice of a doctor.