Cost savings from managing hypertension in primary health care clinics in Kuwait

Abstract

Background: Generic medications are one of the most common solutions for bringing down pharmaceutical costs for both patients and health care providers. Efforts to increase uptake of generics include policies to support generic substitution and prescription. The aim of this study is to estimate the total cost of drugs prescribed by physicians in selected primary health care centers for managing hypertension and the potential cost savings from substituting generic drugs for branded ones. Methods and Findings: One thousand patients with hypertension were randomly selected from the Primary Care Information System database from among patients who sought treatment at three primary health care centers from Al-Jahra governorate in Kuwait from January to December 2018. Generic antihypertensive drugs were substituted for branded ones, and cost savings were calculated by referring to the International Drug Price Indicator Guide. The mean age of 1,000 patients was 57.01 (SD = 11.82) years. Most (57.4%) of the patients were females, and 50.2% were Kuwaitis. The mean number of drugs per prescription was 1.78 (SD = 1.25; range: 1 to 9 drugs). The total number of drugs prescribed was 1,781, with a total cost of KD 10,093 and with a mean of KD 10.09 (SD = 7.34). Only 71 generic drugs had been prescribed, making the generic prescription rate 4.0%. The total number of antihypertensive drugs prescribed was 1,206 (mean: 1.21; SD = 0.46), with a cost of KD 7,678.5 (mean = KD 7.68; SD = 4.06) and with ACE inhibitors as the most prescribed class at 32.19%. Eight hundred ninety antihypertensive drugs were substituted for 774 patients at estimated cost savings of KD 5,675; that is, substituting generic drugs reduced antihypertensive drug cost by 74%. Conclusion: Generic drug prescription appears to be low among primary care physicians in health care centers in Kuwait, but these centers could see substantial cost savings from substituting generic antihypertensive drugs for branded ones. Active interventions are needed to encourage generic prescription among health practitioners to reduce the overall pharmaceutical expenditures.