Bock K D
Zentrum für Innere Medizin, Universität (GHS) Essen, Federal Republic of Germany.
J Hypertens Suppl. 1987 Aug;5(3):S83-5.
The cost of treating hypertension is high. In the Federal Republic of Germany the total sales of antihypertensive compounds increased, from 1981 to 1984, from 1075 million to 1525 million DM per year, corresponding to 7.4 and 9.1%, respectively, of total drug expenditure. Economists have calculated that about two-thirds of this increase is caused by structural changes within the market, i.e. changing prescription patterns. The proportion of prescribed daily doses of reserpine combinations dropped from 52 to 34% whereas that of most other compounds increased. The approximate daily costs of treatment vary from 0.5 DM (reserpine combinations) to 2.5 DM [angiotensin converting enzyme, (ACE) inhibitors], but the decline of the cheaper compounds and their substitution by newer and more expensive drugs has resulted in additional costs of 309-328 million DM. The higher prices of the new drugs should be justified by greater benefits compared with conventional compounds. Assessment of new antihypertensive drugs should include potency, efficacy, number and quality of adverse effects, and impact on quality of life. The evaluation should be performed separately for mild and for more severe forms of hypertension. Some advantages or drawbacks of the newer drugs may be important for small subgroups only.
治疗高血压的费用高昂。在德意志联邦共和国，抗高血压药物的年销售总额从1981年的1.075亿德国马克增至1984年的1.525亿德国马克，分别占药品总支出的7.4%和9.1%。经济学家计算得出，这一增长中约三分之二是由市场结构变化导致的，即处方模式的改变。利血平复方制剂的每日处方剂量比例从52%降至34%，而大多数其他药物的比例则有所上升。治疗的每日费用大致从0.5德国马克（利血平复方制剂）到2.5德国马克[血管紧张素转换酶（ACE）抑制剂]不等，但较便宜药物的用量减少以及被更新、更昂贵的药物所替代，导致额外费用达3.09亿至3.28亿德国马克。与传统药物相比，新药更高的价格应当通过更大的疗效来证明其合理性。对新型抗高血压药物的评估应包括效能、疗效、不良反应的数量和质量，以及对生活质量的影响。评估应分别针对轻度和重度高血压进行。某些新药的优点或缺点可能仅对小部分亚组人群具有重要意义。
