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本文引用的文献

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Health outcomes associated with various antihypertensive therapies used as first-line agents: a network meta-analysis.作为一线药物使用的各种抗高血压疗法相关的健康结局：一项网状Meta分析。
JAMA. 2003 May 21;289(19):2534-44. doi: 10.1001/jama.289.19.2534.
2
A comparison of outcomes with angiotensin-converting--enzyme inhibitors and diuretics for hypertension in the elderly.老年高血压患者使用血管紧张素转换酶抑制剂和利尿剂的疗效比较。
N Engl J Med. 2003 Feb 13;348(7):583-92. doi: 10.1056/NEJMoa021716.
3
The relation between methods and recommendations in clinical practice guidelines for hypertension and hyperlipidemia.高血压和高脂血症临床实践指南中方法与建议的关系。
J Fam Pract. 2002 Nov;51(11):963-8.
4
Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).高危高血压患者随机接受血管紧张素转换酶抑制剂或钙通道阻滞剂与利尿剂治疗的主要结局：抗高血压和降脂治疗预防心脏病发作试验（ALLHAT）
JAMA. 2002 Dec 18;288(23):2981-97. doi: 10.1001/jama.288.23.2981.
5
Distribution of blood pressure and hypertension in Canada and the United States.加拿大和美国的血压分布与高血压情况
Am J Hypertens. 2001 Nov;14(11 Pt 1):1099-105. doi: 10.1016/s0895-7061(01)02211-7.
6
Improved hypertension management and control: results from the health survey for England 1998.改善高血压管理与控制：1998年英格兰健康调查结果
Hypertension. 2001 Oct;38(4):827-32.
7
Changes in the phamacologic treatment of hypertension in the Department of Veterans Affairs 1997-1999: decreased use of calcium antagonists and increased use of beta-blockers and thiazide diuretics.1997 - 1999年退伍军人事务部高血压药物治疗的变化：钙拮抗剂使用减少，β受体阻滞剂和噻嗪类利尿剂使用增加。
Am J Hypertens. 2001 Sep;14(9 Pt 1):957-62. doi: 10.1016/s0895-7061(01)02185-9.
8
Changing provider behavior: an overview of systematic reviews of interventions.改变医疗服务提供者的行为：干预措施系统评价概述
Med Care. 2001 Aug;39(8 Suppl 2):II2-45.
9
PBS/RPBS cost implications of trends and guideline recommendations in the pharmacological management of hypertension in Australia, 1994-1998.1994 - 1998年澳大利亚高血压药物治疗趋势及指南建议对药品福利计划/退休人员药品补贴计划成本的影响
Med J Aust. 2001 Jun 4;174(11):565-8. doi: 10.5694/j.1326-5377.2001.tb143436.x.
10
Effects of ACE inhibitors, calcium antagonists, and other blood-pressure-lowering drugs: results of prospectively designed overviews of randomised trials. Blood Pressure Lowering Treatment Trialists' Collaboration.血管紧张素转换酶抑制剂、钙拮抗剂及其他降压药物的作用：前瞻性设计的随机试验综述结果。降压治疗试验协作组
Lancet. 2000 Dec 9;356(9246):1955-64. doi: 10.1016/s0140-6736(00)03307-9.

将噻嗪类药物作为首选抗高血压药物的潜在节省：成本最小化分析。

The potential savings of using thiazides as the first choice antihypertensive drug: cost-minimisation analysis.

作者信息

Fretheim Atle, Aaserud Morten, Oxman Andrew D

机构信息

Department of Health Services Research, Norwegian Directorate for Health and Social Affairs, N-0031 Oslo, Norway.

出版信息

BMC Health Serv Res. 2003 Sep 8;3(1):18. doi: 10.1186/1472-6963-3-18.

DOI:10.1186/1472-6963-3-18
PMID:12959644
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC201005/
Abstract

BACKGROUND

All clinical practice guidelines recommend thiazides as a first-choice drug for the management of uncomplicated hypertension. Thiazides are also the lowest priced antihypertensive drugs. Despite this, the use of thiazides is much lower than that of other drug-classes. We wanted to estimate the potential for savings if thiazides were used as the first choice drug for the management of uncomplicated hypertension.

METHODS

For six countries (Canada, France, Germany, Norway, the UK and the US) we estimated the number of people that are being treated for hypertension, and the proportion of them that are suitable candidates for thiazide-therapy. By comparing this estimate with thiazide prescribing, we calculated the number of people that could switch from more expensive medication to thiazides. This enabled us to estimate the potential drug-cost savings. The analysis was based on findings from epidemiological studies and drug trials, and data on sales and prescribing provided by IMS for the year 2000.

RESULTS

For Canada, France, Germany, Norway, the UK and the US the estimated potential annual savings were US13.8 million dollars, US37.4 million dollars, US72.2 million dollars, US10.7 million dollars, US119.7 million dollars and US433.6 million dollars, respectively.

摘要

背景

所有临床实践指南均推荐噻嗪类药物作为单纯性高血压治疗的首选药物。噻嗪类药物也是价格最低的降压药。尽管如此，噻嗪类药物的使用量远低于其他药物类别。我们想估算如果将噻嗪类药物用作单纯性高血压治疗的首选药物，潜在的节省费用情况。

方法

对于六个国家（加拿大、法国、德国、挪威、英国和美国），我们估算了正在接受高血压治疗的人数，以及其中适合噻嗪类药物治疗的比例。通过将这一估算结果与噻嗪类药物的处方情况进行比较，我们计算出了可以从更昂贵药物转而使用噻嗪类药物的人数。这使我们能够估算出潜在的药物费用节省情况。该分析基于流行病学研究和药物试验的结果，以及IMS提供的2000年销售和处方数据。

结果

对于加拿大、法国、德国、挪威、英国和美国，估计每年潜在节省分别为1380万美元、3740万美元、7220万美元、1070万美元、1.197亿美元和4.336亿美元。