Trends in cardiovascular drug utilization and drug expenditures in Canada between 1996 and 2001.
BACKGROUND
There is increasing interest in studying trends in drug utilization because drug costs are the fastest growing sector of the health care system.


OBJECTIVE
To focus on the trends in the utilization of and expenditures for cardiovascular drugs in Canada by drug class and by province over a six-year period.


METHODS
Data from the IMS Health Canada CompuScript Audit database were used for this study from the period of February 1996 to January 2002. Patterns of drug utilization and expenditures in Canada were described for cardiovascular drug classes, individual agents within classes and by provincial analyses.


RESULTS
Substantial increases in both the utilization of and the expenditures for cardiovascular medications have occurred in Canada over the last six years. Newer medication classes such as angiotensin converting enzyme inhibitors and statins now comprise the majority of cardiovascular drugs prescribed, along with continued high use of diuretics. Increases in some drug classes, such as angiotensin converting enzyme inhibitors, statins and beta-blockers, appear to be based on trial evidence or guidelines. However, marketing may play a larger role in the increases in use of angiotensin receptor blockers and specific drugs, such as amlodipine besylate and atorvastatin, because their increased utilization cannot be explained by major clinical trial evidence and/or practice guidelines.


CONCLUSIONS
Changes in patterns of cardiovascular drug utilization and expenditures in Canada may be associated with clinical trial evidence, clinical practice guidelines, policy changes and/or marketing initiatives.
Jackevicius
Cynthia A
CA
Pharmacy Department, University Health Network--Toronto General Hospital, Toronto, Ontario, Canada. cynthia.jackevicius@uhn.on.ca
Tu
Karen
K
Filate
Woganee A
WA
Brien
Susan E
SE
Tu
Jack V
JV
D002170:Canada; D002317:Cardiovascular Agents / Q000191:economics*; D016527:Drug Costs / Q000639:trends*; D011307:Drug Prescriptions / Q000191:economics; D004363:Drug Utilization / Q000639:trends*; D005102:Health Expenditures / Q000639:trends*; D006331:Heart Diseases / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D010818:Practice Patterns, Physicians'
D002317:Cardiovascular Agents