Cost allocation in antihypertensive drug therapies


The objective of this paper is to evaluate persistence with treatmentand resources allocation in antihypertensive pharmacotherapy in a’real world' population. An administrative database listing all purchaseddrugs was used to perform a longitudinal analysis. The study includedall new users over 20 years of age receiving a first prescriptionfor amlodipine, atenolol, fosinopril, indapamide, or losartan, inan enrolment period of 12 months. The follow-up period lasted 12months. According to prescriptions dynamics, subjects were classifiedas same therapy, combination, switching, interruption and occasionalutilization. The 34.9% study cohort, persisted with treatment (21.1%on same therapy, 4.7% on combination and 9.1% on switching), while65.1% did not persist (10.9% on interruption and 54.2% on occasionaluse). The overall drug cost accounted for persistent (69.0%) andnonpersistent subjects (31.0%). The annual average cost ranged fromε32.80 for occasional users to ε274.69 for those in combination.In clinical practice, a high percentage of patients do not receiveadequate antihypertensive therapy, since the 65.1% of subjects didnot persist with treatment. This results in a level of pharmaceuticalexpenditure that cannot be considered appropriately allocated.

Expert Review of Pharmacoeconomics & Outcomes Research
Gianluca Baio
Gianluca Baio
Professor of Statistics and Health Economics