Engelsk titel: Fully possible to reduce the costs of hypertension treatment
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Författare:
Wettermark B
;
Ångman A
;
Hjemdahl P
Email: paul.hjemdahl@ki.se
Språk: Swe
Antal referenser: 24
Dokumenttyp:
Översikt
UI-nummer: 09061831
Sammanfattning
ACE inhibitors (ACEi´s) and angiotensin receptor blockers (ARB´s) are equally effective in the treatment of hypertension and heart failure. ARB´s are 10-20 times more expensive than generic ACEi´s in Sweden. Drug and Therapeutics Committees recommend that ARB´s be restricted to ACEi-intolerant patients, and reimbursements for ARB´s have recently been restricted. ARB´s accounted for 38% of expenditures for antihypertensive drugs in Sweden in 2007, but only 14% of the volume. In the population 5% were treated with ACEi´s and 4% with ARB´s, with substantial regional variation. Only half of all patients initiated on ARB´s had tested an ACEi during the preceding 18 months, and for 21% an ARB was the first antihypertensive drug instituted. Prescribing patterns differ markedly between caregivers. In Stockholm, the percentage of ARB´s (of ARB´s + ACEi´s) varied between 17% and 73% in primary healthcare centres. With more cost-effective prescribing ˜500 million SEK annually might be reallocated to other medical needs.