Use of and Spending on Antihypertensive Drugs in the Public Health Subsector of Neuquén Province in 2012-2014

Abstract

INTRODUCTION: Hypertension is a risk factor with high impact on cardiovascular morbidity and mortality. The prescription of antihypertensive drugs does not always follow current recommendations, which represents an inefficient use of resources. OBJECTIVES: To assess the use of antihypertensive medications, costs and adequacy to provincial recommendations. METHODS: Information on antihypertensive medications purchase was obtained from provincial Health Undersecretariat, and deliveries of Plan Remediar for 2012-2014. Drug use was expressed as defined daily doses (DDD) per 1000 inhabitants. RESULTS: Spending on antihypertensive medications accounted for 1.14% of total annual drug spending. The DDD/1000 inhabitants provided were 75.5 in 2012, 86.7 in 2013 and 73.8 in 2014. The provincial public health system funded two thirds, and Plan Remediar the remaining third. The average cost of direct purchase was 79% higher than with public auction purchase. More than two thirds of DDD corresponded to enalapril (EN) and hydrochlorothiazide (HCT). CONCLUSIONS: Spending on antihypertensive drugs represents a minimum fraction of total provincial drug spending. The prescription pattern does not fully adhere to the clinical practice guidelines, with a HCT-EN relationship that is inverse compared to the recommended one. In spite of this, 80% of the dispensed DDD correspond to these two drugs, which is considered a rational use.