INTERNATIONAL RESEARCH & OPINION

Nifedipine-to-felodipine switch cost saving in hypertension

Introduction of a nifedipine-to-felodipine switch programme for patients with hypertension can reduce costs considerably, without compromising BP control or medication tolerability, say investigators from Grady Health System in Atlanta, US.

Grady Health System, a publicly funded teaching institution, implemented a voluntary nifedipine-to­felodipine therapeutic switch programme in 1994. In this programme, patients with hypertension who received controlled release (CR) nifedipine 30 or 60 mg/day were switched to CR felodipine S or 10 mg/day, respectively.

One year after starting the programme, 1029 patients had been switched to felodipine. Analysis involving a sample of 127 switch patients showed that BP control and tolerability were comparable before and after the switch. However, monthly acquisition costs for nifedipine 30 and 60 mg/day during the study period were about 32 and 129% higher than those for felodipine S and 10 mg/day, respectively. Extrapolating the results for these 127 patients to all 1029 patients generated a total cost avoidance of SUS81 975 during the first year of the programme. * Accounting for the costs of the programme** generated a net cost saving of $US65 457.

The investigators estimated that the programme's breakeven point was 3.04 months for patients switched from nifedipine 30mg to felodipine Smg and 1.01 month for those switched from nifedipine 60mg to felodipine 10mg. * Not all patients who were switched during the first year of the programme were switched straight away; therefore, after year one the total annual cost avoidance increased to $USI44 100 as all patients in the population would fulve switched from nifedipine to felodipine at this time. ** Costs, from the institution s perspective, included those asso­ciated with drug acquisition. supplemental antihypertensive drug acquisition, clinic visits, tablet wastage and pharmacist time. Dearing CJ, Briscoe TA. Morgan SM. Block LC. Clinical and economic outcomes of a nifedipine-to-felodipine switch program. Formulary 33 : 448-458. May 1998 Il00666220

1173-550319810172-00091$01.00° Adl. Internetlonel Limited 1998. All right. rnerved PharmacoEconomics & Ourr:omes News 25 Jul 1998 No. 172

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