Health Care Costs Associated with Addition, Titration, and Switching Antihypertensive Medications After First-Line Treatment: Results from a Commercially Insured Sample

Journal of Managed Care & Specialty Pharmacy
Kalyani B Sonawane DeshmukhRichard A Hansen

Abstract

Treatment modifications are necessary for addressing issues related to efficacy and tolerance of first-line monotherapy, but they increase the economic burden on patients and their health plans. Understanding the differences in costs between alternative treatment modification strategies, if any, can serve as a guideline for clinical decision making and for designing cost-containment strategies. To compare the health care utilization costs between (a) addition (i.e., use of free-pill combinations [FPCs] or fixed-dose combinations [FDCs]) and uptitration as alternatives for addressing efficacy issues and (b) switching and downtitration as alternatives for addressing tolerance issues with first-line antihypertensive monotherapy. This is a retrospective cohort study that used the 2008-2012 BlueCross BlueShield of Texas claims database. Patients who had a treatment modification within 12 months of initiating antihypertensive monotherapy were identified. All-cause and disease-related health care utilization costs and drug costs were estimated from the BlueCross BlueShield health plan's perspective over a 12-month period, starting from the date of treatment modification. Propensity score-adjusted generalized linear models were used to...Continue Reading

References

Aug 17, 1999·Journal of Human Hypertension·D E HillemanR L Wurdeman
Feb 12, 2004·The Journal of Clinical Hypertension·Luca Degli EspostiEzio Degli Esposti
Jan 5, 2008·The Journal of Clinical Hypertension·Shadi S SalehDan Belletti
Apr 1, 2004·Expert Review of Pharmacoeconomics & Outcomes Research·Krista A Payne, J Jaime Caro
Jan 26, 2011·Circulation·Paul A HeidenreichUNKNOWN Council on Cardiovascular Surgery and Anesthesia, and Interdisciplinary Council on Quality of Care and Outcomes Research
Dec 19, 2014·Circulation·Dariush MozaffarianUNKNOWN American Heart Association Statistics Committee and Stroke Statistics Subcommittee
Feb 27, 2016·The Journal of Clinical Hypertension·Kalyani B Sonawane DeshmukhRichard A Hansen

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