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Evaluation of anti-hypertensive drug utilisation and cost in Hospital Tengku Ampuan Afzan, Kuantan.

Azarisman S.M.S., and Aszrin A., and Sahimi M.S., and Ngow, Harris, and Marzuki A.O., and Jamalludin A.R., and Sapari S., and Maskon O., (2009) Evaluation of anti-hypertensive drug utilisation and cost in Hospital Tengku Ampuan Afzan, Kuantan. International Medical Journal, 8 (2). pp. 29-36. ISSN 1823-4631

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Affiliations

International Islamic University Malaysia. Kulliyah of Medicine
International Islamic University Malaysia. Kulliyah of Medicine
Hospital Tengku Ampuan Afzan, Kuantan, Malaysia. Dept. of Medicine and Pharmacy
International Islamic University Malaysia. Kulliyah of Medicine
International Islamic University Malaysia. Kulliyah of Medicine
International Islamic University Malaysia. Kulliyah of Medicine
Hospital Tengku Ampuan Afzan, Kuantan, Malaysia. Dept. of Medicine and Pharmacy
Hospital Universiti Kebangsaan Malaysia. Cardiology Unit

Abstract

Introduction: Hypertension is one of the most important risk factors for cardiovascular disease in Malaysia. The prevalence of hypertension nearly doubled over a ten-year period (1986 – 1996). This has resulted in a significant rise in its attendant cost. We aim to review the institutional anti-hypertensive use, the cost incurred and the implications on management in our local setting. Materials and Methods: A retrospective review of the annual cost (2006) of anti-hypertensive medications was undertaken at the Department of Pharmacy, Hospital Tengku Ampuan Afzan, a 600-bed major regional hospital on the east-coast of Malaysia. The total number of prescriptions given out and the total cost per drug is then factored to give the annual cost per drug per person in a percentage of the total annual expenditure.Results: The majority of patients were on either 2 (46.5%) or 3 (25.9%) anti-hypertensives. The most frequently prescribed medications were ACE Inhibitors (33.45%), Calcium channel blockers (29.63%), diuretics (16.67%) and β-blockers (13.64%). In terms of cost however, the Calcium channel blockers constituted the greatest percentage of the annual anti-hypertensive budget (63.67%) compared to ACE Inhibitors at just 20.04% of the annual expenditure. The least costly group of drugs is the diuretic making up 16.67% of the total annual prescriptions but only constituting 1.23% of the annual cost. Conclusion: The majority of patients were on ACE Inhibitors and/or Calcium channel blockers. This has huge monetary implications as they represent a large proportion of the annual antihypertensive allocation. There may be a need to reverse the trend in the developing world due to cost restrictions.

Item Type:Journal
Keywords:Hypertension, Medication, Cost.
Subjects:R Medicine, Dentistry, Pharmacy, Nursing
ID Code:11154

1. Lim, T.O., Morad Z., Hussein R.H., et al. Prevalence, awareness, treatment and control of hypertension in the Malaysian adult population: results from the national health and morbidity survey. Singapore Med J 1996; 45:20-27

2. Omar Z.A., Samad M.I., Abu Bakar R., Kamarudin A..S, Norafizan S, Suhaila W. High blood pressure amongst outpatient clients in government health clinics in Malaysia. NCD Malaysia 2004; 3:24-8

3. Chan, S.C., Chandramani, T., Chen, T.Y., et al. Audit of hypertension in general practice. Medical Journal of Malaysia 2005; 60:475-82

4. Chobanian AV, Bakris GL, Black HR, et al. The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA 2003; 289:2560-72

5. Kostis JB, Davis BR, Cutler J, et al. Prevention of heart failure by antihypertensive drug treatment in older persons with isolated systolic hypertension. SHEP Cooperative Research Group. JAMA 1997; 278:212-6

6. SHEP Cooperative Research Group. Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension. Final results of the Systolic Hypertension in the Elderly Program (SHEP). JAMA 1991; 265:3255-64

7. Staessen JA, Thijs L, Fagard R, et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators. JAMA 1999; 282:539-46

8. Yuen YH, Chang S, Chong CKL, Lee SC, Critchley JAJH, Chan JCN. Drug utilization in a hospital general medical outpatient clinic with particular reference to antihypertensive and antidiabetic drugs.J Clin Pharm Ther 1998; 23:287-94

9. Mehta DK ed. Cardiovascular System. In: British National Formulary. London: Pharmaceutical Press, 1997: 289-301

10. Strube G. Prescribing within a budget. Practitioner 1993; 237:73-5

11. Clinical Practice Guidelines on Management of Acute ST Segment Elevation Myocardial Infarction (STEMI) [online]. (Accessed December 6, 2007, at http://www.acadmed.org.my/html/index.shtml)

12. Chobanian AV et al. Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Seventh Report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. Hypertension 2003; 42:1206–52

13. Williams B, Poulter NR, Brown MJ, et al. Guidelines for management of hypertension: report of the fourth working party of the British Hypertension Society, 2004-BHS IV. J Hum Hypertens 2004; 18:139–85

14. Lithell HOL. Effect of antihypertensive drugs on insulin, glucose and lipid metabolisme. Diabetes Care 1991; 40:203-9

15. Chan JCN, Cockram CS, Critchley JAJH. Drug induced disorders of glucose metabolisme – mechanisms and management. Drug Saf 1996;15:135-57

16. Azarisman S.M.S., Ngow, H.A., Marzuki A.O., et al. Cost-effectiveness of anti-hypertensive medications in a regional hospital in rural Malaysia. J Hypertens 2008; 26(Supp 1):S250

17. Babar Z., Ibrahim M.I.M., Singh, H., Bukhari N.I. A survey of medicine prices availability, affordability and price components in Malaysia using the WHO/HAI methodology (online). (Accessed December 2, 2007, at http://www.haiweb.org/medicineprices/surveys/200410MY/survey_report. pdf)

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