| Economic impact of switching from valsartan to other angiotensin receptor blockers in patients with hypertension. | |
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MedLine Citation:
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PMID: 20141381 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: The approaching availability of lower-cost generic angiotensin receptor blockers (ARBs) may affect formulary policies for patients maintained on the ARB valsartan. OBJECTIVE: Estimate the economic impact of switching from valsartan (including valsartan-based single-pill combinations) to other ARBs without apparent medical reasons. RESEARCH DESIGN AND METHODS: Patients with essential hypertension and at least 6 months of continuous valsartan treatment free of hospitalization, cardiovascular events, renal events or ARB-associated adverse events were identified from the MarketScan administrative claims database from January 1, 2004 to March 31, 2008. Those who subsequently switched to a different ARB with at least a 5% copayment decrease (switchers) were matched to those who did not switch (maintainers) according to propensity score quintiles and selected baseline characteristics. Refills were not required after the index fill for the switched-to ARB or maintained valsartan. Matched switchers and maintainers were compared in terms of medication discontinuation, healthcare resource use and costs during the 6 months following the index fill. RESULTS: A total of 99,926 valsartan maintainers and 2150 switchers (with a mean copayment decrease of $16.5 per month) were identified and matched. After matching, switching from versus maintaining valsartan was associated with an 8% higher risk of medication discontinuation (p < 0.008), 19.1 additional outpatient visits/100 patients (p = 0.002) and 9.3 additional hypertension-related inpatient days/100 patients (p = 0.030). Concurrently, switching from versus maintaining valsartan was associated with higher total medical costs by $748/patient (p < 0.001), driven largely by higher costs for hypertension-related medical services by $492/patient (p = 0.004). LIMITATIONS: Exact reasons for switching were not available and the study assessed only the short-term impacts of switching. CONCLUSIONS: Hypertension patients maintained on valsartan who switched to a different ARB with a lower copayment experienced substantial increases in medication discontinuation, healthcare resource use and costs compared to those who maintained valsartan treatment. |
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Authors:
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J Signorovitch; J Zhang; E Q Wu; D Latremouille-Viau; A P Yu; H B Dastani; K H Kahler |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Current medical research and opinion Volume: 26 ISSN: 1473-4877 ISO Abbreviation: Curr Med Res Opin Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-03-15 Completed Date: 2010-06-16 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0351014 Medline TA: Curr Med Res Opin Country: England |
Other Details:
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Languages: eng Pagination: 849-60 Citation Subset: IM |
Affiliation:
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Analysis Group Inc, Boston, MA 02199, USA. jsignorovitch@analysisgroup.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angiotensin II Type 1 Receptor Blockers / economics*, therapeutic use Cost-Benefit Analysis Deductibles and Coinsurance Drugs, Generic / economics*, therapeutic use Fees, Pharmaceutical* Female Health Care Costs* Health Services / economics, utilization Humans Hypertension / drug therapy* Male Matched-Pair Analysis Medication Adherence Middle Aged Tetrazoles / economics*, therapeutic use United States Valine / analogs & derivatives*, economics, therapeutic use |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin II Type 1 Receptor Blockers; 0/Drugs, Generic; 0/Tetrazoles; 137862-53-4/valsartan; 7004-03-7/Valine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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