RESUMEN
OBJECTIVE: Hypertension is a major issue in public health, and the financial costs associated with hypertension continue to increase. Cost-effectiveness studies focusing on antihypertensive drug combinations, however, have been scarce. The cost-effectiveness ratios of the traditional treatment (hydrochlorothiazide and atenolol) and the current treatment (losartan and amlodipine) were evaluated in patients with grade 1 or 2 hypertension (HT1-2). For patients with grade 3 hypertension (HT3), a third drug was added to the treatment combinations: enalapril was added to the traditional treatment, and hydrochlorothiazide was added to the current treatment. METHODS: Hypertension treatment costs were estimated on the basis of the purchase prices of the antihypertensive medications, and effectiveness was measured as the reduction in systolic blood pressure and diastolic blood pressure (in mm Hg) at the end of a 12-month study period. RESULTS: When the purchase price of the brand-name medication was used to calculate the cost, the traditional treatment presented a lower cost-effectiveness ratio [US$/mm Hg] than the current treatment in the HT1-2 group. In the HT3 group, however, there was no difference in cost-effectiveness ratio between the traditional treatment and the current treatment. The cost-effectiveness ratio differences between the treatment regimens maintained the same pattern when the purchase price of the lower-cost medication was used. CONCLUSIONS: We conclude that the traditional treatment is more cost-effective (US$/mm Hg) than the current treatment in the HT1-2 group. There was no difference in cost-effectiveness between the traditional treatment and the current treatment for the HT3 group.
Asunto(s)
Amlodipino/economía , Antihipertensivos/economía , Atenolol/economía , Hidroclorotiazida/economía , Hipertensión/tratamiento farmacológico , Losartán/economía , Amlodipino/efectos adversos , Antihipertensivos/efectos adversos , Atenolol/efectos adversos , Presión Sanguínea/efectos de los fármacos , Costos de los Medicamentos , Quimioterapia Combinada/economía , Enalapril/administración & dosificación , Enalapril/economía , Femenino , Humanos , Hidroclorotiazida/efectos adversos , Hipertensión/clasificación , Losartán/efectos adversos , Masculino , Persona de Mediana Edad , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
OBJECTIVE: Hypertension is a major issue in public health, and the financial costs associated with hypertension continue to increase. Cost-effectiveness studies focusing on antihypertensive drug combinations, however, have been scarce. The cost-effectiveness ratios of the traditional treatment (hydrochlorothiazide and atenolol) and the current treatment (losartan and amlodipine) were evaluated in patients with grade 1 or 2 hypertension (HT1-2). For patients with grade 3 hypertension (HT3), a third drug was added to the treatment combinations: enalapril was added to the traditional treatment, and hydrochlorothiazide was added to the current treatment. METHODS: Hypertension treatment costs were estimated on the basis of the purchase prices of the antihypertensive medications, and effectiveness was measured as the reduction in systolic blood pressure and diastolic blood pressure (in mm Hg) at the end of a 12-month study period. RESULTS: When the purchase price of the brand-name medication was used to calculate the cost, the traditional treatment presented a lower cost-effectiveness ratio [US$/mm Hg] than the current treatment in the HT1-2 group. In the HT3 group, however, there was no difference in cost-effectiveness ratio between the traditional treatment and the current treatment. The cost-effectiveness ratio differences between the treatment regimens maintained the same pattern when the purchase price of the lower-cost medication was used. CONCLUSIONS: We conclude that the traditional treatment is more cost-effective (US$/mm Hg) than the current treatment in the HT1-2 group. There was no difference in cost-effectiveness between the traditional treatment and the current treatment for the HT3 group.
Asunto(s)
Femenino , Humanos , Masculino , Persona de Mediana Edad , Amlodipino/economía , Antihipertensivos/economía , Atenolol/economía , Hidroclorotiazida/economía , Hipertensión/tratamiento farmacológico , Losartán/economía , Amlodipino/efectos adversos , Antihipertensivos/efectos adversos , Atenolol/efectos adversos , Presión Sanguínea/efectos de los fármacos , Costos de los Medicamentos , Quimioterapia Combinada/economía , Enalapril/administración & dosificación , Enalapril/economía , Hidroclorotiazida/efectos adversos , Hipertensión/clasificación , Losartán/efectos adversos , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
OBJECTIVE: Evaluating differences in the suitable prescription of thiazides in hypertense patients, according to affiliation regime. MATERIALS AND METHODS: This was an analytical cross-sectional study. The database from a previous study was used regarding two groups of hypertense patients (subsidised regime and contributory regime) who had attended out-patient consultation between 01-09-2007 and 29-02-2008. Ideal therapy was evaluated in both groups. Univariate and multivariate analysis was carried out. RESULTS: 136 patients (contributory: 41.9 %; subsidised: 58.1 %). Subsidised regime patients were older (mean=68.8±10) than those from the contributory regime (mean=64.1±11.1) (t-test, p=0.0110). Prescribing antihypertensive drugs was ideal in 49/136 of the patients (36.0 %). Ideal prescription accounted for 24/79 (30 %) of the patients in the subsidised regime and 25/57 (43.8 %) in the contributory one (OR=1.79; 95 % CI:0.88-3.64). Older people (aged ≥ 65 yo) were at risk of receiving a non-ideal prescription (OR=2.12; 95 %CI:1.02-4.38) whilst this was not so in the subsidised regime (OR=1.62; 95 % CI:0.78-3.35). CONCLUSIONS: Ideal prescription of antihypertensive drugs was low in the population being studied. There were differences regarding age ideal prescription but not concerning affiliation regime. It is suggested that a longitudinal study be carried out in the future.
Asunto(s)
Antihipertensivos/uso terapéutico , Diabetes Mellitus Tipo 2/complicaciones , Utilización de Medicamentos/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricos , Hidroclorotiazida/uso terapéutico , Hipertensión/tratamiento farmacológico , Prescripción Inadecuada/estadística & datos numéricos , Factores de Edad , Anciano , Anciano de 80 o más Años , Antihipertensivos/economía , Colombia , Estudios Transversales , Diabetes Mellitus Tipo 2/economía , Utilización de Medicamentos/economía , Financiación Gubernamental , Disparidades en Atención de Salud/economía , Humanos , Hidroclorotiazida/economía , Hipertensión/complicaciones , Hipertensión/economía , Prescripción Inadecuada/economía , Seguro de Salud , Persona de Mediana Edad , Análisis Multivariante , Programas Nacionales de Salud , Factores SocioeconómicosRESUMEN
Objective Evaluating differences in the suitable prescription of thiazides in hypertense patients, according to affiliation regime. Materials and methods This was an analytical cross-sectional study. The database from a previous study was used regarding two groups of hypertense patients (subsidised regime and contributory regime) who had attended out-patient consultation between 01-09-2007 and 29-02-2008. Ideal therapy was evaluated in both groups. Univariate and multivariate analysis was carried out. Results 136 patients (contributory: 41.9 percent; subsidised: 58.1 percent). Subsidised regime patients were older (mean=68.8±10) than those from the contributory regime (mean=64.1±11.1) (t-test, p=0.0110). Prescribing antihypertensive drugs was ideal in 49/136 of the patients (36.0 percent). Ideal prescription accounted for 24/79 (30 percent) of the patients in the subsidised regime and 25/57 (43.8 percent) in the contributory one (OR=1.79; 95 percent CI:0.88-3.64). Older people (aged ≥ 65yo) were at risk of receiving a non-ideal prescription (OR=2.12; 95 percentCI:1.02-4.38) whilst this was not so in the subsidised regime (OR=1.62; 95 percent CI:0.78-3.35). Conclusions Ideal prescription of antihypertensive drugs was low in the population being studied. There were differences regarding age ideal prescription but not concerning affiliation regime. It is suggested that a longitudinal study be carried out in the future.
Objetivo Evaluar las diferencias en la adecuada prescripción de tiazidas en pacientes hipertensos, según régimen de afiliación. Materiales y métodos Estudio de corte transversal analítico. Se utilizó la base de datos de un estudio previo, dos grupos de pacientes hipertensos: régimen subsidiado y régimen contributivo que asistieron a consulta externa entre el 01-09-2007 y el 29-02-2008. Se evaluó terapia ideal en los dos grupos. Se realizó análisis univariado y multivariado. Resultados Se estudiaron 136 pacientes (contributivo: 41,9 por ciento; subsidiado: 58,1 por ciento). Los pacientes del régimen subsidiado fueron mayores (promedio= 68,8±10) que los del contributivo (promedio=64,1±11.1) (t-test, p=0,0110). La prescripción de antihipertensivos fue ideal en 49/136 (36,0 por ciento). En el régimen subsidiado la prescripción fue ideal en 24/79 (30 por ciento) y en el contributivo en 25/57 (43,8 por ciento) (OR: 1,79 IC95 por ciento (0,88-3,64)). La edad ≥65años fue riesgo de prescripción no ideal (OR: 2.12, IC95 por ciento(1,02-4,38)), mientras que no lo fue estar en el régimen subsidiado (OR=1,62, IC95 por ciento(0,78-3,35). Conclusiones La prescripción ideal de antihipertensivos es baja. Hay diferencias en la edad, en la prescripción ideal, mas no por régimen de afiliación. Se sugiere un estudio longitudinal en el futuro.