Abstract

IDENTIFICATION, ASSESSMENT AND ANALYSING THE COST EFFECTIVENESS OF ANTIHYPERTENSIVES FOR PHARMACOECONOMIC EVALUATION IN A TERTIARY CARE TEACHING HOSPITAL

Joyson B.S., Merin Sara Jacob, Feba Mathew and Jobin Thomas, Sushilkumar P. L.*

ABSTRACT

A prospective observational study was conducted for a period of 6 months in general medicine IPD of SSIMS & RC. In-patients who were diagnosed with hypertension and receiving treatment specifically with antihypertensive agents were included in the study. Among all Antihypertensive agents, the most cost-effective drug or combination in the hospital was identified. A total of 64 patients were enrolled in the study and was observed that, Telmisartan (40mg) was the most commonly prescribed antihypertensive monotherapy and Telmisartan + Hydrochlorothiazide (40mg+80mg) was the most commonly prescribed antihypertensive combination therapy. In the study we have found that Furosemide (40mg) was found to be more cost-effective drug in reducing both systolic as well as diastolic blood pressure with ACER of 7.592 and 21.08 respectively. Amlodipine + Atenolol (5mg+50mg) was found to be more cost-effective in reducing SBP with ACER of 60.48 and Torsemide + Spironolactone (10mg+50mg) in reducing DBP with ACER of 77.05 among combinational antihypertensives used. ICER was also calculated and it was found that Rs. 18.75 and Rs. 468 was extra required while using Nifedipine than Furosemide for achieving respective maintenance value of SBP and DBP respectively. In most patients, the cost of monthly antihypertensive therapy was relatively high and hence there is a need of rational prescribing which includes more generic drugs so that the therapy is economical for the patients. Development and implementation of formulary or a manual of comparative drug prices in all hospitals is mandatory for the physicians to prescribe generic and cost-effective drugs.

Keywords: Pharmacoeconomic evaluation, Cost-effective analysis, Hypertension, Antihypertensive agents.