The potential savings of using thiazides as the first choice antihypertensive drug: cost-minimisation analysis.
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.
Fretheim
Atle
A
Department of Health Services Research, Norwegian Directorate for Health and Social Affairs, N-0031 Oslo, Norway. atle.fretheim@shdir.no
Aaserud
Morten
M
Oxman
Andrew D
AD
D000328:Adult; D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use*; D001581:Benzothiadiazines; D002170:Canada; D017046:Cost Savings / Q000706:statistics & numerical data*; D003657:Decision Making; D004232:Diuretics; D016527:Drug Costs / Q000706:statistics & numerical data*; D011307:Drug Prescriptions / Q000191:economics; D004363:Drug Utilization / Q000191:economics / Q000592:standards; D005060:Europe; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics*; D017410:Practice Guidelines as Topic; D012680:Sensitivity and Specificity; D049993:Sodium Chloride Symporter Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D014481:United States
D000959:Antihypertensive Agents; D001581:Benzothiadiazines; D004232:Diuretics; D049993:Sodium Chloride Symporter Inhibitors