Background All clinical practice guidelines recommend thiazides as a first-choice drug for the management of uncomplicated hypertension. studies and drug trials and data on sales and prescribing provided by IMS for the year 2000. Outcomes For Canada France Germany Norway the united kingdom and the united states the approximated potential annual cost savings had been US$13.8 million US$37.4 million US$72.2 million US$10.7 million US$119.7 million and US$433.6 million respectively. Conclusions Huge amount of money could be preserved every year if thiazides had been recommended for hypertension instead of more expensive medicines. Our calculations derive from traditional assumptions. The prospect of savings is probable considerably higher and could become more than US$1 billion each year in america. Background Systematic testimonials of randomized managed trials never have demonstrated superiority for just about any course of antihypertensive medication [1 2 Nevertheless the avoidance of coronary disease is better noted for some medication classes than others . The data that first range thiazides work in reducing the chance of coronary disease is particularly solid [1 3 These medications are also one of the better tolerated antihypertensives . Furthermore thiazides are definitely the lowest costed antihypertensive drugs. Therefore all scientific practice suggestions recommend thiazides either as the just first choice medication for the administration of easy hypertension or among the first-line agencies . However thiazides are recommended much less often than various other antihypertensives [6-9]. For instance in Norway the cost of bendroflumethiazide is usually 1/10 of that of amlodipine (a calcium channel blocker) which is one of the most expensive drugs used in the management of elevated blood pressure . Despite its high cost amlodipine is the best selling antihypertensive drug in Norway both in terms of cost and in terms of dosages . Amlodipine has also been the largest-selling antihypertensive drug worldwide (US$3.4 billion in 2000) . This achievement is particularly amazing considering that evidence for the drug’s effectiveness in preventing cardiovascular disease has been lacking. The low use of thiazides may be caused by misconceptions concerning possible problems with the use of thiazides and Rabbit Polyclonal to Cytochrome P450 7B1. the extensive promotion of other more expensive medications . We wanted to estimate the potential for drug cost savings if more rational prescribing practices were employed. Rational prescribing would in this case mean using thiazides as the drug of choice in the management of hypertension when there is not an indication for selecting an alternative drug. Methods We compared the direct drug costs of current prescribing of antihypertensive medication with the costs if thiazides were selected as the first choice drug for the management of hypertension. The analysis was done for six countries: Canada France Germany Norway the UK and the US. Based on the results of systematic reviews we assumed (S)-Amlodipine that thiazides and other antihypertensives are equally effective medication for uncomplicated hypertension with regards to health outcomes [1 2 Consequently we performed a cost-minimisation study where we calculated drug costs (S)-Amlodipine associated with thiazide and (S)-Amlodipine non-thiazide treatment for uncomplicated hypertension. We calculated the potential for savings on direct drug expenses from the perspective of drug-payers using sales values to calculate costs. We did not include value added tax (VAT) in the drug prices because antihypertensives are largely paid for by the public in the majority of the countries we studied. When drugs are reimbursed with public funds VAT simply represents a transfer of funds between the reimbursing agency and the treasury and not as such a real cost to the public sector. All economic figures are reported in US dollars for the (S)-Amlodipine year 2000. The price 12 months was 2000. We used the “defined daily dose” (DDD) being a measure for the assumed typical dose used for every medication . The DDD is preferred by The Globe Health Firm as a typical measure for make use of in medication utilization research . By convention we portrayed consumption of medications as DDDs/1000 inhabitants/time which might serve as an estimation from the percentage of the populace receiving the medications. An estimated intake of 10 DDDs/1000 inhabitants/time corresponds to a (S)-Amlodipine regular usage of 1% of the populace. Potential usage of thiazides for the.