title: Current trends in treatment of hypertension in Karachi and cost minimization possibilities.
abstract: OBJECTIVE
  This study finds out drug usage trends in Stage I Hypertensive Patients without any compelling indications in Karachi, deviations of current practices from evidence based antihypertensive therapeutic guidelines and looks for cost minimization opportunities.
  
  
  METHODS
  In the present study conducted during June 2012 to August 2012, two sets were used. Randomized stratified independent surveys were conducted in doctors and general population - including patients, using pretested questionnaires. Sample sizes for doctors and general population were 100 and 400 respectively. Statistical analysis was conducted on Statistical Package for Social Science (SPSS). Financial impact was also analyzed.
  
  
  RESULTS
  On the basis of patients' doctors' feedback, Beta Blockers, and Angiotensin Converting Enzyme Inhibitors were used more frequently than other drugs. Thiazides and low-priced generics were hardly prescribed. Beta blockers were prescribed widely and considered cost effective. This trend increases cost by two to ten times.
  
  
  CONCLUSIONS
  Feedbacks showed that therapeutic guidelines were not followed by the doctors practicing in the community and hospitals in Karachi. Thiazide diuretics were hardly used. Beta blockers were widely prescribed. High priced market leaders or expensive branded generics were commonly prescribed. Therefore, there are great opportunities for cost minimization by using evidence-based clinically effective and safe medicines.
authors.affiliation: Izhar M. Hussain, M. Pharm., MBA. Director, Center for Executive Education, Institute of Business Administration, IBA City Campus, Garden / Kiyani Shaheed Road, Karachi, Pakistan.
authors.forename: Izhar M
authors.initials: IM
authors.lastname: Hussain
authors.affiliation: Dr. Baqir S. Naqvi, PhD. Professor, Department of Pharmaceutics, Faculty of Pharmacy, Hamdard University, Karachi, Pakistan.
authors.forename: Baqir S
authors.initials: BS
authors.lastname: Naqvi
authors.affiliation: Rao M. Qasim, Pharm. D, M. Phil., MBA Institute of Business Management, Karachi, Pakistan.
authors.forename: Rao M
authors.initials: RM
authors.lastname: Qasim
authors.affiliation: Nasir Ali, MBA Supply Chain Management, Research Executive, IBA Center for Executive Education, Karachi, Pakistan.
authors.forename: Nasir
authors.initials: N
authors.lastname: Ali
keywords: Compelling indications; Cost minimization; Evidence-based therapeutic guidelines; Initial therapy; Stage I hypertension