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Discrepancies between use of antihypertensive drugs and guidelines indications: pharmacoeconomic implications

Journal of Human Hypertension volume 19, pages 819–822 (2005)Cite this article

Hypertension is, in Italy, the most common disease encountered by medical practitioners, and the pathological changes produced by elevated arterial pressure are the principal cause of death.1 Antihypertensive drug therapy reduces the risk of hypertension-related morbidity and mortality; and new drugs, which promise greater efficacy and fewer adverse effects than older drugs, attract physicians. In Italy, the expenditure for antihypertensives reached, in the year 2003, the sum of 991.35 million euro;2 subtracting from this sum the expenditure due to the use of the same drugs for diseases other than hypertension, that in Italy, is generally estimated to be in the aggregate around 15%, the total expenditure for the therapy of hypertension may be considered to be approximately 840 million euro. The progressively increasing number of subjects potentially eligible to an antihypertensive treatment and the high cost of more recent drugs suggest that both benefit/risk and cost/effectiveness ratios should be carefully considered in the choice of the antihypertensive(s).

The aims of this study were (i) to analyse, in terms of both defined daily doses (DDDs) and expenditure, the use of the various classes of antihypertensive drugs in the Italian Liguria Region during the years 1999–2003; and (ii) to verify to what extent the treatment of hypertensive patients was carried out taking into account the indications of the guidelines. The analysis was based on information provided by the database of the Pharmaceutical Department of the region. The antihypertensive drugs were those included in the following classes of the Anatomic Therapeutic Chemical (ATC) classification of the European Pharmaceutical Market Association: C02-antihypertensives (methyldopa, clonidine, α-adrenergic receptor antagonists, and minoxidil), C03-diuretics, C07-β-adrenergic receptor antagonists, C08-calcium channel antagonists, and C09-drugs acting on the renin–angiotensin system (angiotensin-converting enzyme inhibitors, and angiotensin II-receptor antagonists).

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Clinical Pharmacology and Toxicology, University of Genoa, Viale Benedetto XY 2, Genoa, Italy

    L Robbiano, A Martelli & G Brambilla

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  1. L Robbiano
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  2. A Martelli
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  3. G Brambilla
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Correspondence to G Brambilla.

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Robbiano, L., Martelli, A. & Brambilla, G. Discrepancies between use of antihypertensive drugs and guidelines indications: pharmacoeconomic implications. J Hum Hypertens 19, 819–822 (2005). https://doi.org/10.1038/sj.jhh.1001900

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