PRESCRIBING PATTERN AND COST EFFECTIVENESS ANALYSIS OF ANTIHYPERTENSIVE DRUGS IN CHRONIC KIDNEY DISEASE PATIENTS

Alwyn P Saju, Ankur C Edakkarayil, Maheswari E*, Gurudev KC

ABSTRACT

Introduction: Cost effectiveness analysis (CEA) is used to determine the clinical and economical effectiveness in Chronic Kidney Disease (CKD) patients. Objectives: To study the prescribing pattern of antihypertensive drugs in CKD and to analyse the cost effectiveness of drug therapies to manage hypertension in CKD. Methodology: A prospective, observational study in CKD patients in outpatient department of a tertiary care hospital. All CKD patients with a history of hypertension or diabetes mellitus or both were included. Patients with other causes were excluded. Study procedure: The prescriptions were screened to determine the prescribing pattern. The cost effectiveness of antihypertensive drugs was calculated using the incremental cost-effectiveness ratios. Result: The study was conducted in 200 patient in which majority were men. Mean of age and drugs per prescription was found to be 51.96 12.67 and 6.49 ± 2.55 respectively. 37% and 32.5% of the study population was prescribed with two antihypertensive drugs and one antihypertensive drug respectively. Calcium channel blockers (70%) were the most prescribed class of antihypertensive drug. Amlodipine (44.5%) is the most prescribed antihypertensive agent. In patients who were on single antihypertensive drug, calcium channel blockers were found to be more cost effective. Conclusion: Use of antihypertensive drugs in CKD patients does not deviate from the guidelines laid down by National Kidney Foundation Kidney Disease Outcome Quality Initiative guidelines. Pharmacoeconomic analysis shows that Calcium channel blockers were the most cost effective antihypertensive in CKD patients when compared to other antihypertensive drugs when used alone.

Keywords: Prescribing pattern, chronic kidney disease, cost effectiveness analysis.