The Clinical and Economic Implications of Drug Utilization Patterns in the Treatment of Hypertension with ACE Inhibitors and Calcium Channel Blockers in a Managed Care Setting

Abstract

ABSTRACT: Hypertension is the number one reason for visits to a physician, accounting for roughly one in 10 visits. Despite extensive expenditures on the disease, only 20% of patients are well controlled. This longitudinal patient review (LPR) analysis was performed as an initial step in modeling the impact of unsuccessful outcomes in patients whose initial treatment was either an angiotensin converting enzyme inhibitor (ACEI) or a calcium channel blocker (CCB) as first-line pharmacologic therapy. In addition, the cost impact of these changes was measured pre- and post-modification in terms of pharmacy costs per member per month (PMPM). The study was conducted by retrospectively analyzing pharmacy claims data from six managed care plans of multiple designs. The outcomes measured were the number, type, and first-year acquisition cost of modifications of an antihypertensive drug (AD) in compliant, newly diagnosed hypertensive patients initiated on either an ACEI or CCB. Over the initial 12 months of therapy...