[Cost of cardiovascular risk factor prevention in middle-aged French men. The PRIME study]

Little is known regarding the cost of cardiovascular risk factor prevention in France. In this study, we assessed the cost of antihypertensive and hypolipidaemic drug treatment in middle-aged French men without history of coronary heart disease.

A cross-sectional study was conducted between 1991 and 1993 in 1606 subjects treated for hypertension or dyslipidaemia from the three French centres participating in the PRIME study. The daily cost of treatment (in Euros) was assessed using data from the Agence Nationale du Médicament.

Mean daily cost of hypertension was 0.65 euro per patient; after multivariate adjustment, obese subjects had a mean daily cost of 0.74+/-0.03 euro (adjusted mean +/- standard error) versus 0.66+/-0.03 euro for non-obese (p<0.001). Only 58% of hypertensive subjects were adequately controlled, and this percentage was higher in the Toulouse centre (80.1%) than in Lille (44.4%) or Strasbourg (50.2%), p<0.001. Fibrates were the most frequently prescribed hypolipidemic drug; nevertheless, prescription of statins was higher than fibrates in the Toulouse centre, which led to a higher mean daily cost for dyslipidaemia, which was further confirmed by multivariate adjustment: 0.59+/-0.05 euro (adjusted mean +/- standard error) in Toulouse versus 0.44+/-0.04 euro in Lille and 0.44+/-0.04 euro in Strasbourg. Only 54% of treated dyslipidemic subjects had their lipid levels within normal values, and this percentage was significantly lower (44%) in Strasbourg than in Lille (58%) or Toulouse (59%) (p<0.001).

The prescription of anti-hypertensive or hypolipidemic drugs differs according to centre, leading to significant differences in mean daily cost of treatment. A considerable percentage of treated subjects is not adequately controlled, with possible consequences at the economical level.