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Related Experiment Videos

HOPE study impact on ACE inhibitors use.

Michiel E H Hemels1, Heather A Bennett, Lori Bonari

  • 1Graduate Department of Pharmacology, University of Toronto, Toronto, Ontario, Canada. m.hemels@utoronto.ca

The Annals of Pharmacotherapy
|April 24, 2003
PubMed
Summary

Angiotensin-converting enzyme (ACE) inhibitor prescriptions and costs significantly increased in Canada. The Heart Outcomes Prevention Evaluation (HOPE) trial publication correlated with a dramatic rise in ramipril use, unlike other ACE inhibitors.

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Area of Science:

  • Pharmacology
  • Cardiovascular Medicine
  • Health Economics

Background:

  • Cardiovascular diseases are leading causes of death in Canada.
  • Angiotensin-converting enzyme (ACE) inhibitors are crucial for managing these conditions.
  • The Heart Outcomes Prevention Evaluation (HOPE) study demonstrated ramipril's efficacy in high-risk patients.

Purpose of the Study:

  • To analyze trends in ACE inhibitor utilization and associated costs in Canada.
  • To evaluate the impact of the HOPE study publication on ramipril's market share.
  • To compare the growth patterns of ramipril against other ACE inhibitors.

Main Methods:

  • Utilized pharmacy and hospital sales data from IMS Canada (1985-2001).
  • Focused on Anatomical Therapeutic Category code C09A0 (ACE inhibitors) across three major provinces.

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  • Analyzed prescription numbers, total costs, cost per prescription, and market share using regression analysis.

    • Main Results:

    • Overall ACE inhibitor prescriptions surged from 356,000 (1985) to 11.5 million (2001).
    • Total costs escalated linearly from $14.5 million to $513 million (USD) during the study period.
    • Ramipril's market share dramatically increased from 9.2% (1999) to 32.8% (2001) post-HOPE trial publication.

    Conclusions:

    • ACE inhibitor prescriptions and total expenditures rose substantially between 1985 and 2001.
    • Ramipril's increased utilization directly coincided with the HOPE trial's findings.
    • Other ACE inhibitors exhibited consistent, non-accelerated growth rates during the same period.