The Collison Newsletter February 2010


                  DRUGS – The TOP 10 for 2008-2009*  


The ‘Top 10 Drugs’ for the last four years have been discussed in my July 2006, February 2007, January 2008 and January 2009 newsletters, especially looking at the ‘quick fix’ drug approach versus lifestyle change.


The Australian Prescriber (volume 32, number 6, December 2009) lists the top 10 drugs for 2008-2009. These were the subsidised drugs (ie, those part-paid by the Australian Government direct to the pharmaceutical companies) prescribed under the PBS (Pharmaceutical Benefits Scheme) or RPBS (Repatriation PBS). The data supplied does not include private prescriptions (ie those fully paid by the patient). The source of the information was the Drug Utilisation Sub-committee Drug Utilisation Database (Commonwealth of Australia) as at 28th September 2009.


This newsletter will only look at the ‘Top 10 drugs by Cost to the Government’.


There have been two changes to the list since 2007-2008. Omeprazole and tiotropium have been replaced by ranibizumab and rituximab.

Table 1. Top 10 drugs by cost to the Government, 2008-2009  


Position in 2007-2008Cost A$
1.  atorvastatin(1)621,164,182
2.  clopidogrel(3)210,600,588
3.  esomeprazole(4)205,083,299
4.  rosuvastatin(8)201,708,668
5.  simvastatin(2)170,511,054
6.  salmeterol & fluticasone(5)164,181,553
7.  olanzapine(6)158,870,974
8.  ranibizumab(-)154,941,222
9.  rituximab(-)112,256,755
10. venlafaxine(9)111,236,036


Brand Name: Lipitor
 Also an ingredient in Caduet
 Hypolipidaemic agent. A ‘statin’
clopidogrelBrand Names: Iscover, Plavix
 Platelet aggregation inhibitor
esomeprazoleBrand Name: Nexium
 Proton pump inhibitor. Treatment of peptic ulcers
rosuvastatinBrand Name: Crestor
 Hypolipidaemic agent. A ‘statin’
simvastatinBrand Names: multiple including Lipex, Ransim, Simvar, Zimstat and Zocor
 Hypolipidaemic agent.A ‘statin’
salmeterol & fluticasoneBrand Name: Seretide
 For asthma prophylaxis
olanzapineBrand Name: Zyprexa
 Antipsychotic agent
 Treatment of schizophrenia and related psychoses
ranibizumabBrand name: Lucentis
 Treatment of macular degeneration
rituximabBrand name: Mabthe
 Monoclonal antibody, antineoplastic agent
 Treatment of cancers (chemotherapy)
venlafaxineBrand Name: Efexor
 Selective serotonin reuptake inhibitor
 Treatment of depression

Table 2. Total Cost to the Government (A$) of the top 10 Drugs  

2004 -2005

2005 -20061,982,069,629
2006 - 20071,919,232,000
2007 - 20081,941,276,630
2008 -20092,110,554,331

It can be seen that the cost to the Government (taxpayers) changed little from 2004 to 2008. However, in the past year there has been an increase of almost 170 million dollars.

Statin Drugs 

Three of the top 10 drugs continue to be statins, hypolipidaemic agents used to lower cholesterol levels in the blood. In 2007-2008, the combined cost of these three (atorvastitin, simvastatin and rosuvastatin) was A$927,613,203 from just under 18 million prescriptions. This was actually A$37million less than 2006-2007, which was a significant reversal of the progressively increasing cost of these statin drugs over the previous 3 years. However 2008-2009 showed a jump, in the combined cost of these 3 statins, of almost 66 million dollars from the previous year. The amount was A$993,383,904 from 19.28 million prescriptions.

Should Statin Drugs be Avoided?

Statin drugs work by inhibiting an enzyme in the liver that is needed to manufacture cholesterol. The possible side effects resulting from statin drugs are set out in my August 2009 newsletter Statins – Adverse Reactions.


In my January 2009 newsletter about the top 10 drugs, I pointed out that with a lifestyle change (treating the problem of overweight/obesity and the metabolic syndrome, having an ideal diet which is dominantly alkaline as well as regular exercise, stress management, rest and relaxation) there could be a dramatic reduction in the intake of drugs, the ‘quick fix’, especially the statin group of drugs.


It takes time, discipline, motivation and understanding to find the underlying causes of diseases and to deal with them. It takes the same dedication for an individual to embrace a healthy lifestyle in order to prevent disease or to help in the treatment/management of disease if it is already present. Many of these issues have been dealt with in past newsletters and I would encourage you to scroll back over these and reread the information and guidelines set out therein.


*Copyright 2010: The Huntly Centre.

Disclaimer: All material in the website is provided for informational or educational purposes only. Consult a health professional regarding the applicability of any opinions or recommendations expressed herein, with respect to your symptoms or medical condition.


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