Evaluation of Pharmacoeconomics and Prescription Trends of Antihypertensive Medications at Various Clinical Settings of Hyderabad, Pakistan

Abstract

Pharmacoeconomics is the branch of health-economics where cost and outcomes are compared for patient’s treatment therapies and services in a health care system. Hypertension is one of the most common serious medical conditions in Pakistan and throughout the world. A large number of antihypertensive medications alone or in combinations are being prescribed. Pharmaco-economic studies are helpful in prescribing the most appropriate medication with required outcomes at minimum cost. Objective of study was to assess the prescription trends and cost-effectiveness among different classes of antihypertensive medications prescribed at different clinical setups of Hyderabad, Pakistan. A Prospective observational study was carried out at cardiac OPD of Liaquat University Hospital, Hyderabad from April 2018 to April 2019. According to inclusion and exclusion criteria, 400 prescriptions containing antihypertensive Drugs were collected via purposive sampling technique for pharmacoeconomic analysis during the study period. In Government setting, Monotherapy (83%) was more frequent than combination therapy (17%). The most frequent and the most cost-effective monotherapy was Enalapril maleate 5 mg having cost/day 4 Rs. In combination therapies, Lisinopril 20 mg + HTZ 12.5 mg was the most frequent. Spironolactone 50 mg + furosemide 40 mg was found to be the most cost-effective combination with cost/day 5 Rs. In private settings, the trends of antihypertensive monotherapy (75.5%) were more frequent than combination therapy (24.5%). The most frequent monotherapy was Telmisartan 40 mg while the most frequent antihypertensive combination was Amlodipine besylat 10 mg + Valsartan 160 mg. Metoprolol tartarate 100 mg and lisinopril 5 mg were cost-effective monotherapies with cost/day 5 Rs each and the combination of candesartancelexetil 16 mg + HTZ 12.5 mg was the most cost-effective. It is concluded from the current study that the prescription trends of antihypertensive medications were relatively cost-effective at Government setting but overall, the antihypertensive treatment cost was high which puts a substantial economic burden on patients.