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Although recent evidence suggests that the clinical benefit may beuncertain for fibrates, a class of drugs used for the treatment ofhigh lipid levels, use of these drugs is common in the U.S. andCanada, with usage increasing steadily in the last decade in theU.S., especially for a brand-name fibrate product, according to astudy in the March 23/30 issue of JAMA . Two studies in the last 5 years that included the use of fenofibrate failed to show a benefit in reducing cardiovascular events. "Thesenegative studies raise questions about a medication with more than$1 billion in sales in the United States," according to backgroundinformation in the study. "The main evidence for clinical benefitcomes from placebo-controlled trials with the older fibrates suchas gemfibrozil (for which some safety concerns were raisedprimarily when used with cerivastatin) and clofibrate (which is nolonger available due to safety concerns). These trials exertsubstantial influence in meta-analyses that show that fibrates inaggregate significantly reduce cardiac events but not overallmortality. The relevance of this older evidence to contemporarypractice is uncertain, particularly given that the only trial toassess fibrates in a population taking statins yielded negativeresults." Little is known about how fibrates are used in practice. Cynthia A. Jackevicius, Pharm.D., M.Sc., of Western University ofHealth Sciences, Pomona, Calif., and colleagues examined trends inthe current use of fibrates in the United States and Canada. Thestudy included data from the United States and Canada of patientsprescribed fibrates between January 2002 and December 2009, andexpenditures associated with those prescriptions. In the United States, fibrate prescriptions dispensed increasedfrom 336 prescriptions/100,000 population in January 2002 to 730prescriptions/100,000 population in December 2009, an increase of117.1 percent. In Canada, fibrate prescriptions increased from 402prescriptions/100,000 population in January 2002 to 474prescriptions/100,000 population in December 2009, an increase of18.1 percent. In the United States, fenofibrate prescriptions dispensed increasedfrom 150 prescriptions/100,000 population in January 2002 to 440prescriptions/100,000 population in December 2009. In Canada,fenofibrate prescriptions increased from 321 prescriptions/100,000population in January 2002 to 429 prescriptions/100,000 populationin December 2009. "Estimated fenofibrate use was relativelyconstant between 2002 and 2009 in Canada, while in the UnitedStates, use increased by 159.3 percent," the authors write. In the United States, crude fenofibrate costs increased from$11,535/100,000 population/month in 2002 to $44,975/100,000population/month in 2009, while in Canada, the costs declined forfenofibrate from $17,695/100,000 population/month in 2002 to$16,112/100,000 population/month in 2009. Adjusted estimatedfibrate expenditures per 100,000 population were approximately3-fold higher in 2009 in the United States compared with Canada. The researchers also found that there was a strong preferenceobserved for prescribing brand-name over generic fenofibrateproducts in the United States, but not in Canada. "Access differences to generic fenofibrate between the UnitedStates and Canada likely contributed to the vastly differentpatterns of fenofibrate use, and are associated with a greateconomic burden for U.S. consumers and third-party payers," theauthors write. "Fibrates are used commonly in the United States and Canada. Usehas increased steadily in the United States over the last decadedespite published negative results from fibrate trials in patientswith diabetes who were also taking statins; however, fibrate use in Canada hasremained stable. Fenofibrate dominates the market despite it havingthe least supportive clinical outcomes evidence. While this growthin the setting of a strong preference for brand-name over genericfenofibrate in the United States has been associated with highermedication costs, improvement in clinical outcomes is uncertain." JAMA. 2011;305[12]1217-1224. I am an expert from inflatable-amusementpark.com, while we provides the quality product, such as Inflatable Amusement Park Manufacturer , Inflatable Lighting Decoration, Inflatable Amusement Park,and more.
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