PBS/RPBS cost implications of trends and guideline recommendations in the pharmacological management of hypertension in Australia, 1994–1998

OBJECTIVES: To determine the extent to which "current guidelines" for the management of hypertension are reflected in the prescribing of antihypertensive drugs in Australia over the period 1994-1998, and to examine the cost implications of actual and recommended prescribing patterns. DESIGN: Federal Government and consumer cost estimates modelled on prescribing patterns and guideline recommendations over the period 1994-1998. SETTING: Prescribing on Federal Government pharmaceutical schemes over the 1994-1998 period. MAIN OUTCOME MEASURES: Estimates of Pharmaceutical Benefits Scheme/Repatriation Pharmaceutical Benefits Scheme cost changes in Australian dollar values. RESULTS: The implementation of current guidelines for patients with uncomplicated hypertension taking monotherapy alone could have reduced drug costs by $45-$108 million in 1998. CONCLUSIONS: Current prescribing patterns indicate that clinical practice has pre-empted the results from clinical trials of newer, more expensive agents and that clinicians' prescribing patterns do not closely reflect current recommendations.