Pharmacoeconomic analysis of antihypertensive drugs and evaluation of quality of life, an observational study in patients with hypertension, GGH, Anantapuramu

Introduction: Hypertension is one of the leading cause of global burden of disease and as it is a chronic condition with significant detrimental effects on the wide range of health outcomes, cost effective management of hypertension a appears to be a great challenge for both developed as well as developing countries eventhough recently there have been lot of studies on pharmaco- economics and out come research in the field of hypertension globally, but the results cannot be exactly extrapolated to Indian scenario as the economic status and socio economics factors are different in India as compared to the countries. Hence a study was undertaken to evaluate the cost effectiveness of antihypertensive drugs in our hospital. Objectives: To evaluate the prescription pattern, cost effective antihypertensive therapy and quality of (QoL) of the patients. Materials and Methods: An observational comparative study is planned on 100 patients Attending the outpatient Department of General medicine at GGH, Ananthapuramu from JUNE 2018 to DECEMBER 2018 with a follow up period of 6 months. Written informed consent is obtained from all the patients satisfying the inclusion criteria. In first visit, a detailed history is taken regarding the disease (hypertension) duration, co morbid condition, socio economic status, duration of antihypertensive therapy. Blood pressure and pulse is recorded, drug therapy details noted like pattern (monotherapy or multi drug therapy), costs of the drugs, dosage of the drug and changes in the drug therapy. After 6 months, again same details are collected. The details so obtained regarding the different patterns of drug therapy are analysed for the cost effectiveness. Statistical tests used for analysis are Chi square Test and “T” test. The QoL is evaluated with SF – 30 questionnaire. Results: Multitherapy was frequently prescribed (74%), out of that Atenolol with amlodipine. combination was most common (54%) , Diabetes was the most common co- morbid condition (24%). In mono therapy Amlodipine proved to be more cost effective (CER of 8.93) then Atenolol (CER 18.15) (p-0.0059) and in multitherapy Amlodipine with Enalapril combination was more cost effective *CER 18.24) then Amlodipine with Atenolol (CER 27.73) with (p-0.057). Conclusion: Multitherapy was most frequently prescribed, and Amlodipine with Enalapril combination proved to be most cost effective therapy. HRQoL was not much different in all the treatment groups.