Pattern of use and pharmacoeconomic impact of antihypertensive drugs in a north Indian referral hospital

Abstract.

Objective: The current study was designed to investigate drug utilisation and the pharmacoeconomics of hypertension in the hypertension clinic of a tertiary-care hospital. Methods: The study was conducted in patients attending the hypertension clinic of Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh, India. A survey of prescriptions was carried out, and the information obtained was further corroborated by seeing the medical records as well as patient interviews. Results: A total of 1076 prescriptions were evaluated. Beta-adrenoceptor-blocking agents (51%), calcium antagonists (47%) and angiotensin-converting enzyme inhibitors (46%) were the most popular drugs. The utilisation of thiazides was less than expected. Combination therapy was used more commonly than monotherapy (53.8% vs 46.7%). Oral hypoglycaemic agents and lipid-lowering agents were commonly co-prescribed along with antihypertensive medications. About 30% of drugs were prescribed by generic name and 90% were from the national essential drugs list. Of the per capita income, 10.6% was spent on the treatment of hypertension. The mean monthly cost of various drugs ranged between US $0.8 and US $6.6. A total of 91 adverse drug reaction (ADRs) were encountered in the study; the added cost of treatment of these ADRs was US $211. Conclusion: In general, the treatment guidelines for hypertension were followed in our hospital. The utilisation of thiazides was an area requiring improvement. The cost of treatment of hypertension was substantial and imparted a significant economic burden on the patients.