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Changing prescription patterns: impact on costs.

K D Bock1

  • 1Zentrum für Innere Medizin, Universität (GHS) Essen, Federal Republic of Germany.

Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension
|August 1, 1987
PubMed
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The increasing cost of hypertension treatment in Germany is driven by a shift from cheaper drugs to more expensive ones, like angiotensin converting enzyme (ACE) inhibitors. This change adds hundreds of millions of DM annually to healthcare expenses.

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.

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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.