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高血压成年人中抗高血压药物的使用和费用。

The uses and expenses of antihypertensive medications among hypertensive adults.

机构信息

School of Pharmacy, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston, MA, 02115, USA.

Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention (CDC), 4770 Buford Highway, NE, Atlanta, GA, 30341, USA.

出版信息

Res Social Adm Pharm. 2020 Feb;16(2):183-189. doi: 10.1016/j.sapharm.2019.05.002. Epub 2019 May 8.

Abstract

BACKGROUND

The literature lacks information about the use and cost of prescribed antihypertensive medications, especially by the type and class of medication prescribed.

OBJECTIVE

This study investigated the uses and expenses of antihypertensive medications among hypertensive adults in the United States.

METHODS

Using the 2014-2015 Medical Expenditure Panel Survey data, adult men and nonpregnant women aged 18 or older who had a diagnosis code of hypertension and used any prescribed antihypertensive medication were included in the study (n = 10,971). Adults with hypertension who were using a single antihypertensive medication were defined as single medication users, and those using two or more medications were defined as multiple medication users. Medications were classified into angiotensin-converting-enzyme inhibitors (ACEIs), angiotensin receptor blockers (ARBs), calcium channel blockers (CCBs), thiazide-type diuretics (TDs), β-blockers (BBs), and others. The average annual total antihypertensive medication expenses and the expenditures of each medication class were estimated by using generalized linear models with a log link and gamma distribution and were adjusted to 2015 US dollars.

RESULTS

Among 10,971 hypertensive adults, 4759 (44.1%) were single medication users, and 6212 (55.9%) were multiple medication users. The average annual total cost for antihypertensive medications was $336 per person (95% confidence interval [CI] = $319-$353); $199 (95% CI = $177-$221) for single medication users and $436 (95% CI = $413-$459) for multiple medication users. The average annual costs for each medication class were estimated at $438 (95% CI = $384-$492) for ARBs and $49 for TDs (95% CI = $44-$55).

CONCLUSIONS

Users of multiple medications incurred more than twice the expense than single medication users. When comparing classes of medications, the cost for ARBs was the highest, whereas the cost for TDs was the lowest. This information can be used in evaluating the cost-effectiveness of antihypertension therapies.

摘要

背景

文献中缺乏有关处方降压药物使用和成本的信息,尤其是按处方药物的类型和类别。

目的

本研究调查了美国高血压成年患者使用降压药物的情况和费用。

方法

利用 2014-2015 年医疗支出面板调查数据,纳入患有高血压诊断代码且使用任何处方降压药物的成年男性和非孕妇(年龄≥18 岁)(n=10971)。使用单一降压药物的高血压成人被定义为单一药物使用者,使用两种或多种药物的被定义为多种药物使用者。药物分为血管紧张素转换酶抑制剂(ACEI)、血管紧张素受体阻滞剂(ARB)、钙通道阻滞剂(CCB)、噻嗪类利尿剂(TD)、β受体阻滞剂(BB)和其他。使用对数链接和伽马分布的广义线性模型估计了每年平均的降压药物总费用和每类药物的支出,并调整为 2015 年的美元。

结果

在 10971 名高血压成人中,4759 名(44.1%)为单一药物使用者,6212 名(55.9%)为多种药物使用者。降压药物的年人均总成本为 336 美元(95%置信区间[CI]:319-353);单一药物使用者为 199 美元(95%CI:177-221),多种药物使用者为 436 美元(95%CI:413-459)。估计每种药物类别的年平均费用分别为 ARB 类药物 438 美元(95%CI:384-492)和 TD 类药物 49 美元(95%CI:44-55)。

结论

使用多种药物的患者费用是单一药物使用者的两倍多。在比较药物类别时,ARB 类药物的费用最高,而 TD 类药物的费用最低。这些信息可用于评估抗高血压治疗的成本效益。

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