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Compliance, persistence, and switching patterns for ACE inhibitors and ARBs
Stefan Vegter1, Nhu Ho Nguyen, Sipke T Visser
1Unit of Pharmaco-Epidemiology and PharmacoEconomics, Department of Pharmacy, University of Groningen, Antonius Deusinglaan 1, 9713 AV Groningen, The Netherlands. s.vegter@rug.nl
The American Journal of Managed Care
|September 10, 2011
Summary
Compliance and persistence rates for angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) were similar. However, ACE inhibitor users switched therapies more often, primarily to ARBs.
Area of Science:
- Cardiovascular pharmacotherapy
- Drug utilization research
- Hypertension management
Background:
- Angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are cornerstone therapies for cardiovascular conditions.
- Understanding patient adherence and treatment patterns is crucial for optimizing therapeutic outcomes.
Purpose of the Study:
- To compare compliance, persistence, and switching patterns between ACE inhibitors and ARBs.
- To identify variations in these behaviors among specific agents within each drug class.
Main Methods:
- A large-scale drug-utilization analysis was performed using prescription data.
- Data from over 50,000 incident users of ACE inhibitors or ARBs were analyzed for nearly 200,000 patient-years.
- Compliance, persistence, and switching patterns were assessed and adjusted for demographic and clinical factors.
Main Results:
- One-year compliance and three-year persistence rates were statistically similar between ACE inhibitors and ARBs.
- Patients using ACE inhibitors demonstrated significantly higher rates of switching therapy compared to ARB users.
- Switching from ACE inhibitors predominantly occurred towards ARBs; variations were noted among specific ACE inhibitors but not ARBs.
Conclusions:
- Compliance and persistence are comparable between ACE inhibitors and ARBs, suggesting similar patient adherence.
- Switching behavior differs, with a notable tendency to transition from ACE inhibitors to ARBs.
- Prescribing generic ARBs may be more cost-effective given similar efficacy and adherence profiles.
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