What is the rate of persistence and associated cost allocation for new users of antihypertensive therapies in a real-world population?
A high percentage (65.1%) of patients initiating antihypertensive therapy do not persist with treatment, leading to inappropriately allocated pharmaceutical expenditure.
The objective of this paper is to evaluate persistence with treatment and resources allocation in antihypertensive pharmacotherapy in a 'real world' population. An administrative database listing all purchased drugs was used to perform a longitudinal analysis. The study included all new users over 20 years of age receiving a first prescription for amlodipine, atenolol, fosinopril, indapamide, or losartan, in an enrolment period of 12 months. The follow-up period lasted 12 months. According to prescriptions dynamics, subjects were classified as same therapy, combination, switching, interruption and occasional utilization. The 34.9% study cohort, persisted with treatment (21.1% on same therapy, 4.7% on combination and 9.1% on switching), while 65.1% did not persist (10.9% on interruption and 54.2% on occasional use). The overall drug cost accounted for persistent (69.0%) and nonpersistent subjects (31.0%). The annual average cost ranged from euro32.80 for occasional users to euro274.69 for those in combination. In clinical practice, a high percentage of patients do not receive adequate antihypertensive therapy, since the 65.1% of subjects did not persist with treatment. This results in a level of pharmaceutical expenditure that cannot be considered appropriately allocated.
Esposti et al. (Tue,) studied this question.