@entity1 adherence to generic versus brand statin therapy after @entity583 : Insights from the Can Rapid Stratification of Unstable Angina XXXX Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines Registry.

@entity1 @entity583 @entity6817
BACKGROUND: @entity6817 reduce mortality after @entity583 , but up to half of @entity1 discontinue statin use within 1 year of therapy initiation. Although cost may influence medication adherence, it is unknown whether use of generic versus brand @entity6817 influences adherence. METHODS AND RESULTS: We linked detailed inhospital clinical data for 1421 non-ST-segment elevation @entity583 @entity1 discharged on a statin in 2006 to Medicare Part D medication claims records to examine postdischarge medication use. One-year statin adherence was defined using the proportion of days covered with optimal adherence >= 80%. We examined the association of brand versus generic statin prescription and 1-year adherence after adjusting for demographics, clinical factors, predischarge lipid values, prior statin use, and socioeconomic status. Overall, 65.5% of statin fills were for brand-name @entity6817 . There were few baseline differences in demographics and clinical factors among generic versus brand users. @entity1 copay amounts were higher for brand versus generic @entity6817 (median =  25 vs  5, P < .001), yet the mean proportion of days covered over 1 year was similar (71.5% vs 68.9%; P = .97; unadjusted odds ratio 1.15 [95% CI 0.96-1.37]). Proportion of days covered >= 80% was low for both generic (56.2%) and brand @entity6817 (55.9%; P = .93). Statin adherence rates remained similar between generic and brand users after adjusting for demographics, clinical risk factors, lipid value, prior statin use, and socioeconomic status. CONCLUSIONS: In a cohort of older non-ST-segment elevation @entity583 @entity1 , we found no evidence that use of generic versus brand drug was associated with higher adherence to @entity6817 at 1 year after hospital discharge.
