Changing prescription patterns: impact on costs.

Area of Science:

• Pharmacoeconomics
• Cardiovascular Medicine
• Health Economics

Background:

• The cost of treating hypertension is a significant concern, with expenditures rising substantially between 1981 and 1984 in Germany.
• Antihypertensive drug sales increased from 1075 million to 1525 million DM annually, representing 7.4% to 9.1% of total drug expenditure.

Purpose of the Study:

• To analyze the economic impact of changing prescription patterns in antihypertensive drug use.
• To evaluate the cost-effectiveness of newer antihypertensive medications compared to conventional treatments.

Main Methods:

• Analysis of drug sales data and prescription patterns in the Federal Republic of Germany from 1981 to 1984.
• Calculation of daily treatment costs for different classes of antihypertensive drugs, including reserpine combinations and angiotensin converting enzyme (ACE) inhibitors.

Main Results:

• Structural market changes, specifically altered prescription patterns, accounted for approximately two-thirds of the increase in antihypertensive drug expenditure.
• The proportion of prescribed daily doses of reserpine combinations decreased from 52% to 34%, while other compounds increased.
• The substitution of cheaper drugs with newer, more expensive ones resulted in additional costs of 309-328 million DM annually.

Conclusions:

• The shift towards more expensive antihypertensive drugs, such as ACE inhibitors, has significantly increased treatment costs.
• Newer antihypertensive drugs require justification through superior benefits, including efficacy, safety, and quality of life impact, compared to conventional options.
• Comprehensive drug evaluation should differentiate between mild and severe hypertension and consider subgroup-specific advantages or disadvantages.