Study of the efficiency in the prescription of antihypertensive agents based on efficacy according to the atom study results

Abstract

Background/Aim The hypertension is the persistent elevation of SBP ≥ 140 and/or DBP ≥ 90 mmHg. It is the most common condition seen in primary care, approximately 7% of the outpatient visits are due to hypertension. On average, a hypertensive patient would cost twice that of a normotensive individual, because hypertension is a risk factor for other diseases. The aim of the study is to calculate the cost-effectiveness of the reduction and control of hypertension using antihypertensive active ingredients. There are only few studies comparing the efficacy and/or effectiveness of the most commonly used antihypertensive drugs. Materials and methods This study is based mainly in the Atom study, a systematic review of clinical trials followed by a meta-regression. A cost-effectiveness study has been completed through the application of the concept of Law et al. and by the ICER analysis. Results This work compares the effectiveness and cost-effectiveness of different antihypertensive drugs commonly used in clinical practice. According to the data analysed, the most cost-effectiveness treatments are (depending on the blood pressure reduction interval): Enalapril 10, Amlodipine 5, Enalapril 20 + Amlodipine 5, Bisoprolol 5, Enalapril 20 + Indapamide 1.25, Enalapril 20 + HCTZ 12.5, Olmesartan 40 + Amlodipine 10 + HCTZ 25 and Enalapril 20 + HCTZ 12.5 + Amlodipine 10. Also, it has been proven that the results of the study are in agreement with the antihypertensive treatments prescribed in the current clinical practice in the sanitary region of Girona. Conclusions The effectiveness analysis and the pharmacoeconomic study provide new information about antihypertensive active ingredients, with the objective of being able to apply it in the usual clinical practice. This knowledge would potentially help the clinician to choose the most adequate treatment and improve the health of patients