PCV59 - Utilization of Angiotensin Receptor Blockers In Ministry Of Health Institutions, Malaysia

Abstract

Ministry of Health Medicines Formulary (MOHMF) is a list of approved drugs to be used in the Ministry of Health Malaysia institutions. As more drugs are listed into the formulary each year, the MOHMF Review Panel has requested to relook at the Angiotensin Receptor Blockers (ARBs) used in the MOH Institutions (hospitals and health clinics). The objective of this study is to review the adoption and utilization of ARBs in the MOH institutions. As of September 2016, four types of ARBs with 25 different strengths of single and combination tablets available were listed in the MOHMF. Based on the ARBs listed, a cross-sectional study on usage of ARBs was conducted among the Asia countries namely Thailand, India, Singapore, Indonesia and South Korea. In addition, a survey was sent to MOH institutions (hospitals and health clinics) in September 2016 to March 2017 to obtain a feedback on the availability of ARBs in their local setting. The utilisation estimates were calculated using data for public sector, extracted from the IMS Health (Malaysia) database from 2012 until 2016. The defined daily dose (DDD) per 1000 inhabitants per day was calculated. On average, both hospitals and health clinics kept 11 different strengths of ARBs in the local formulary. Single agents ARBs are most commonly used in the MOH facilities. Up to 2015, the most commonly used ARB was telmisartan, followed by irbesartan, losartan and valsartan. From 2016 onwards, losartan become the most used ARB single agent. Similarly, the cross-sectional survey showed losartan was most commonly used among the Asia countries. However, Malaysia reimbursed the most ARBs while most countries choose to reimburse between two and three ARBs. The result of this study can help to formulate the investment and disinvestment policy on ARBs in the MOH Medicines Formulary.