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Analysis of acquisition and the monthly cost of antihypertensive therapy with modern fixed-dose combinations in the Far Eastern Federal District

https://doi.org/10.17749/2070-4909/farmakoekonomika.2021.061

Abstract

Objective: analyzing the acquisition and monthly costs for patients on modern fixed-dose antihypertensive combinations in three regions of the Far Eastern Federal District.

Material and methods. Intra-group analysis of retail of antihypertensive drugs for 2019 in drugstores of the Khabarovsk Region, Sakhalin Region, Amur Region (n=100) was carried out. The calculation of the monthly cost of therapy was performed and total sales indicators were identified. Statistical analysis: dispersion analysis, Spearman's rank correlation coefficient, Kruskal–Wallis test.

Results. The maximum demand in patients among combinations of -blockers in the price range of 100-500 rubles: atenolol+chlortalidone; bisoprolol+amlodipine. In the grope of combinations of angiotensin-converting enzyme inhibitors with diuretics/calcium channel blockers, the most often acquired were: perindopril/ramipril+indapamide/amlodipine, enalapril+hydrochlorothiazide – in the price segment of 500–1000 rubles. Preferences for the use of combinations of angiotensin II receptor blockers+diuretic/calcium channel blockers: valsartan+amlodipine with a monthly cost of therapy of 300–500 rubles; losartan+hydrochlorothiazide – 100–500 rubles and azilsartan+chlortalidonee – 500–1000 rubles. The most popular three-component drugs were valsartan+amlodipine+hydrochlorothiazide, perindopril+amlodipine+indapamide with a monthly cost over 500 rubles. Differences in the acquisition structure of fixed-dose antihypertensive combinations between regions were statistically significant.

Conclusion. The share of sales of combined antihypertensive drugs remains insignificant. The main selection criteria within an international nonproprietary name are affordability or trust in a brand. The presence of a reliable correlation of the acquisition structure with the region proves the influence of regional preferences of specialists in drug prescribing.

About the Authors

M. S. Soboleva
Far-East State Medical University
Russian Federation

Mariya S. Soboleva – PhD (Biol.), Associate Professor, Chair for Pharmacy and Pharmacology. RSCI SPIN-code: 6819-5236

35 Muravyev-Amurskiy Str., Khabarovsk 680000



E. E. Loskutova
Peoples’ Friendship University of Russia
Russian Federation

Ekaterina E. Loskutova – Dr. Pharm. Sci., Chief of Chair for Organization and Economics of Pharmacy, Medical Institute. RSCI SPIN-code: 1133-0394

8k2 Miklukho-Maklay Str., Moscow 117198



References

1. Hazra N.C., Rudisill C., Jackson S.H., Gulliford M.C. Cost-effectiveness of antihypertensive therapy in patients older than 80 years: cohort study and Markov model. Value Health. 2019; 22 (12): 1362–9. https://doi.org/10.1016/j.jval.2019.08.001.]

2. Gu D., He J., Coxson P.G., et al. The costeffectiveness of low-cost essential antihypertensive medicines for hypertension control in China: a modelling study. PLoS Med. 2015; 12 (8): e1001860. https://doi.org/10.1371/journal.pmed.1001860.

3. González-Gómez S., Meléndez-Gomez M.A., López-Jaramillo P. Fixed-dose combination therapy to improve hypertension treatment and control in Latin America. Arch Cardiol Mex. 2018; 88 (2): 129−35. https://doi.org/10.1016/j.acmx.2017.06.001.

4. Moran A.E., Odden M.C., Thanataveerat A., et al. Cost-effectiveness of hypertension therapy according to 2014 guidelines. N Engl J Med. 2015; 372 (5): 447–55. https://doi.org/10.1056/NEJMsa1406751.

5. Salam A., Huffman M.D., Kanukula R., et al. Two-drug fixed-dose combinations of blood pressure-lowering drugs as WHO essential medicines: an overview of efficacy, safety, and cost. J Clin Hypertens (Greenwich). 2020; 22 (10): 1769–79. https://doi.org/10.1111/jch.14009.

6. Düsing R., Waeber B., Destro M., et al. Triplecombination therapy in the treatment of hypertension: a review of the evidence. J Hum Hypertens. 2017; 31 (8): 501−10. https://doi.org/10.1038/jhh.2017.5.

7. Laurent S., Bejan-Angoulvant T., Boutouyrie P. Prescription of fixed dose combinations of antihypertensive drugs. Rev Prat. 2019; 69 (10): 1094−8.

8. Mazón P., Galve E., Gómez J., et al. Medical expert consensus in AH on the clinical use of triple fixed-dose antihypertensive therapy in Spain. Hipertens Riesgo Vasc. 2016; 33 (4): 133–44. https://doi.org/10.1016/j.hipert.2016.03.001.

9. Ishida T., Oh A., Hiroi Sh., et al. Treatment patterns and adherence to antihypertensive combination therapies in Japan using a claims database. Hypertens Res. 2019; 42 (2): 249−56. https://doi.org/10.1038/s41440-018-0127-0.

10. Bramlage P., Schmidt S., Sims H. Fixed-dose vs free-dose combinations for the management of hypertension – аn analysis of 81 958 patients. J Clin Hypertens (Greenwich). 2018; 20 (4): 705−15. https://doi.org/10.1111/jch.13240.

11. Deshmukh K.B., Qian J., Garza K.B., et al. Health сare сosts associated with addition, titration, and switching antihypertensive medications after first-line treatment: results from a commercially insured sample. J Manag Care Spec Pharm. 2017; 23 (6): 691−9. https://doi.org/10.18553/jmcp.2017.23.6.691.

12. Wang X., Chen H., Ej E., et al. Cost-effectiveness analysis of antihypertensive triple combination therapy among patients enrolled in a Medicare advantage plan. Expert Rev Pharmacoecon Outcomes Res. 2020: 1–8. https://doi.org/10.1080/14737167.2020.1800457.

13. Xie X., He T., Kang J., et al. Cost-effectiveness analysis of intensive hypertension control in China. Prev Med. 2018; 111: 110−4. https://doi.org/10.1016/j.ypmed.2018.02.033.

14. Ziyad A., Yasser A., Adnan A., et al. Соst-effectiveness of more intensive blood pressure treatment in patients with high risk of cardiovascular disease in Saudi Arabia: a modelling study of metaanalysis. Int J Hypertens. 2019; 2019: 6019401. https://doi.org/10.1155/2019/6019401.

15. Clinical guidelines. Arterial hypertension in adults. 2020. Russian Society of Cardiology. Available at: https://scardio.ru/content/Guidelines/Clinic_rek_AG_2020.pdf (in Russ.) (accessed 26.03.2021).

16. Healthcare in Russia 2019. Appendix to the collection (information in the context of the subjects of the Russian Federation). Available at: https://rosstat.gov.ru/folder/210/document/13218 (in Russ.) (accessed 26.03.2021).

17. Directory of Russian organizations. Medicine. Pharmacies. Available at: https://www.orgpage.ru/rossiya/аптеки/ (in Russ.) (accessed 26.03.2021).

18. Error and sample size calculator. FDF group. Available at: https://fdfgroup.ru/poleznayainformatsiya/stati/vyborka-tipy-vyborokraschet-oshibki-vyborki/#1_anchor (in Russ.) (accessed 26.03.2021).

19. Koshevoy O.S., Karpova M.K. Determination of the volume of sample population during regional sociological research. News of Higher Education Institutions. Volga Region. Social Sciences. 2011; 2(18): 98−104 (in Russ.).

20. ATC/DDD Index. Available at: https://www.whocc.no/atc_ddd_index/?code=C (accessed 26.03.2021).


Review

For citations:


Soboleva M.S., Loskutova E.E. Analysis of acquisition and the monthly cost of antihypertensive therapy with modern fixed-dose combinations in the Far Eastern Federal District. FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology. 2021;14(1):41-49. (In Russ.) https://doi.org/10.17749/2070-4909/farmakoekonomika.2021.061

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