title: Drug treatment and cost of cardiovascular disease in Australia.
abstract: Australia's Pharmaceutical Benefits Scheme supports the use of effective drugs for the prevention and control of cardiovascular risk factors. However, there are little data available describing per person costs of medication in primary prevention and secondary prevention in the community. We aim to understand annual expenditure on cardiovascular medicines according to the level and extent of cardiovascular disease, using participants enrolled in the Reduction of Atherothrombosis for Continued Health (REACH) registry. 2873 participants were recruited into the REACH registry through 273 Australian general practices. Cardiovascular medicines review was undertaken at baseline. Average weighted costs of medications were estimated using government-reimbursed prices. Annual costs were stratified by disease extent and location. The annual mean cost of pharmaceuticals per person was 1307 AU dollars. The average reported medicine use per person across all states and participants groups varied significantly. Participants with cerebrovascular or peripheral arterial disease were prescribed less cardiovascular medication than those with coronary artery disease (CAD) (mean number of drugs 3.5 vs. 4.5, P < 0.0001) and (3.6 vs. 4.5, P < 0.0001), while those with risk factor alone had the same medication use as those with CAD (mean number 4.5). Medication use was lower in Western Australia in comparison to eastern States. Participants with existing cerebrovascular disease and peripheral vascular disease receive less preventive therapy than those with CAD or even risk factors alone. This observation is consistent across all mainland states. Given the evidence of the effectiveness and cost-effectiveness of treating all types of vascular diseases, the present study suggests that there is scope to improve the treatment of these high-risk participants in Australia.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Centre for Cardiovascular Research and Education in Therapeutics, Monash University, Victoria 3004, Australia. Zanfina.Ademi@med.monash.edu.au
authors.forename: Zanfina
authors.initials: Z
authors.lastname: Ademi
authors.forename: Danny
authors.initials: D
authors.lastname: Liew
authors.forename: Derek
authors.initials: D
authors.lastname: Chew
authors.forename: Greg
authors.initials: G
authors.lastname: Conner
authors.forename: Louise
authors.initials: L
authors.lastname: Shiel
authors.forename: Mark
authors.initials: M
authors.lastname: Nelson
authors.forename: Ash
authors.initials: A
authors.lastname: Soman
authors.forename: Gabriel
authors.initials: G
authors.lastname: Steg
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: Christopher
authors.initials: C
authors.lastname: Reid
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use; D050197:Atherosclerosis / Q000188:drug therapy / Q000453:epidemiology; D001315:Australia / Q000453:epidemiology; D015992:Body Mass Index; D002317:Cardiovascular Agents / Q000191:economics* / Q000600:supply & distribution / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000191:economics* / Q000453:epidemiology; D004651:Employment; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000191:economics / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000191:economics / Q000627:therapeutic use; D012042:Registries; D012307:Risk Factors; D012424:Rural Population; D012959:Socioeconomic Factors; D013383:Suburban Population; D014505:Urban Population
chemical_list: D000959:Antihypertensive Agents; D002317:Cardiovascular Agents; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D010975:Platelet Aggregation Inhibitors