MedicalResearch.com Interview with:
Kalyani B. Sonawane, PhD
Assistant Professor/ PhD Program Director
Department of Health Services Research, Management and Policy
College of Public Health and Health Professions
University of Florida
Gainesville, FL 32610
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Almost one-third of Americans have high blood pressure. Of those patients who are prescribed medication to control their blood pressure, about 30 percent have problems with side effects and nearly 50 percent will not have their blood pressure controlled within the first year of taking medication. In such scenarios, physicians have the option to either add a medication, such as fixed-dose combination, to the patient’s regimen or gradually increase a patient’s dose of their current drug to achieve blood pressure control; and gradually decrease the dose of their current drug or switch to a different drug to resolve side effects. Using healthcare claims data, we compared the economic impact of these alternative treatment modification strategies.
MedicalResearch.com: What should readers take away from your report?
Response: Patients and physicians are often reluctant to use fixed-dose combinations because they are expensive. For instance, in our study we found that fixed-dose combinations cost an average of $310 a year compared with $135 for switching to a new drug, $63 for gradually increasing the dose of the current medication, and $61 for gradually decreasing the current drug.
However, this initial cost is offset by savings of up to seven times in hospitalization costs. While the hospitalization costs related to blood pressure or cardiovascular issues averaged $1,731 for patients on fixed-dose combination in our study, costs were $2,985 for patients on decreasing doses of their medication, $7,076 for patients who switched to a new blood pressure drug and $7,692 for patients on increasing doses. In addition to cost savings, previous research shows that fixed-dose combinations have higher efficacy, patients continue on these medications for a longer period of time and have better adherence with these medications.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Our study provides an insight to the differences in annual healthcare costs by treatment modification strategies. It will be interesting to understand differences in lifetime costs and clinical outcomes of these alternative treatment strategies.
MedicalResearch.com: Is there anything else you would like to add?
Response: Data and database support for this study was provided by the University of Texas School of Public Health/BlueCross BlueShield of Texas research program in payment systems and policy.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Kalyani B. Sonawane Deshmukh, Jingjing Qian, Kimberly B. Garza, Bradley M. Wright, Peng Zeng, Cecilia M. Ganduglia Cazaban, Richard A. Hansen. 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, 2017; 23 (6): 691 DOI: 10.18553/jmcp.2017.23.6.691
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