Quality of care and attributable healthcare costs in diabetic hypertensive patients initiated on calcium antagonist therapy

John J. Barron, Ibrahim Al-Zakwani, Thomas Iarocci

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background and objective: Calcium antagonists (CAs) from two classes - dihydropyridine and non-dihydropyridine (DCAs and NDCAs, respectively) - are important add-on agents in goal blood pressure (BP) attainment. This study compared drug regimens to which DCAs or NDCAs had been added; for each class, BP reduction and healthcare costs were evaluated in a diabetic hypertensive population. Design, setting and patients: This was a retrospective observational study using administrative claims data within two US health plans. Patients with diabetes mellitus (DM) and hypertension initiated on CA therapy between 1 January 2000 through 30 June 2002 were identified; the date the first CA prescription (CA-Rx) was filled in this period was labelled the index date. Inclusion required plan enrolment for 6 months pre- and 1 year post-index, no CA-Rx 6 months pre-index, and medication possession ratio >50% for 1 year post-index. Patients fell into either dihydropyridine or non-dihydropyridine study groups. Main outcome measures and results: For each group, costs (amounts allowed by plans, in US dollars; actual costs for 2000-2002) were calculated for resources attributable to DM/hypertension. A total of 5551 patients met eligibility criteria (NDCA = 1515; DCA = 4036). Most had been taking other antihypertensive I medications: 86% and 76% in the DCA and NDCA groups, respectively. The NDCA group had lower annual attributable costs than the DCA group ($US1637 [95% CI $US1479, $US1813] vs $US1989 [95% CI $US1823, $US2170]; p <0.004). A total of 313 medical charts were reviewed (DCA = 242, NDCA = 71). Both groups had similar pre-and post-index BP values; mean changes in systolic and diastolic BP were not statistically significant between groups. Only 22% of all patients attained the recommended systolic/diastolic BP goal of

Original languageEnglish
Pages (from-to)641-649
Number of pages9
JournalClinical Drug Investigation
Volume24
Issue number11
DOIs
Publication statusPublished - 2004

Fingerprint

Quality of Health Care
Health Care Costs
Blood Pressure
Calcium
Costs and Cost Analysis
Therapeutics
Diabetes Mellitus
Hypertension
Antihypertensive Agents
Observational Studies
Prescriptions
Retrospective Studies
Outcome Assessment (Health Care)
Health
Pharmaceutical Preparations
Population

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology

Cite this

Quality of care and attributable healthcare costs in diabetic hypertensive patients initiated on calcium antagonist therapy. / Barron, John J.; Al-Zakwani, Ibrahim; Iarocci, Thomas.

In: Clinical Drug Investigation, Vol. 24, No. 11, 2004, p. 641-649.

Research output: Contribution to journalArticle

@article{c28b0baa35ac4ac5b929560b8bd508ec,
title = "Quality of care and attributable healthcare costs in diabetic hypertensive patients initiated on calcium antagonist therapy",
abstract = "Background and objective: Calcium antagonists (CAs) from two classes - dihydropyridine and non-dihydropyridine (DCAs and NDCAs, respectively) - are important add-on agents in goal blood pressure (BP) attainment. This study compared drug regimens to which DCAs or NDCAs had been added; for each class, BP reduction and healthcare costs were evaluated in a diabetic hypertensive population. Design, setting and patients: This was a retrospective observational study using administrative claims data within two US health plans. Patients with diabetes mellitus (DM) and hypertension initiated on CA therapy between 1 January 2000 through 30 June 2002 were identified; the date the first CA prescription (CA-Rx) was filled in this period was labelled the index date. Inclusion required plan enrolment for 6 months pre- and 1 year post-index, no CA-Rx 6 months pre-index, and medication possession ratio >50{\%} for 1 year post-index. Patients fell into either dihydropyridine or non-dihydropyridine study groups. Main outcome measures and results: For each group, costs (amounts allowed by plans, in US dollars; actual costs for 2000-2002) were calculated for resources attributable to DM/hypertension. A total of 5551 patients met eligibility criteria (NDCA = 1515; DCA = 4036). Most had been taking other antihypertensive I medications: 86{\%} and 76{\%} in the DCA and NDCA groups, respectively. The NDCA group had lower annual attributable costs than the DCA group ($US1637 [95{\%} CI $US1479, $US1813] vs $US1989 [95{\%} CI $US1823, $US2170]; p <0.004). A total of 313 medical charts were reviewed (DCA = 242, NDCA = 71). Both groups had similar pre-and post-index BP values; mean changes in systolic and diastolic BP were not statistically significant between groups. Only 22{\%} of all patients attained the recommended systolic/diastolic BP goal of",
author = "Barron, {John J.} and Ibrahim Al-Zakwani and Thomas Iarocci",
year = "2004",
doi = "10.2165/00044011-200424110-00003",
language = "English",
volume = "24",
pages = "641--649",
journal = "Clinical Drug Investigation",
issn = "1173-2563",
publisher = "Adis International Ltd",
number = "11",

}

TY - JOUR

T1 - Quality of care and attributable healthcare costs in diabetic hypertensive patients initiated on calcium antagonist therapy

AU - Barron, John J.

AU - Al-Zakwani, Ibrahim

AU - Iarocci, Thomas

PY - 2004

Y1 - 2004

N2 - Background and objective: Calcium antagonists (CAs) from two classes - dihydropyridine and non-dihydropyridine (DCAs and NDCAs, respectively) - are important add-on agents in goal blood pressure (BP) attainment. This study compared drug regimens to which DCAs or NDCAs had been added; for each class, BP reduction and healthcare costs were evaluated in a diabetic hypertensive population. Design, setting and patients: This was a retrospective observational study using administrative claims data within two US health plans. Patients with diabetes mellitus (DM) and hypertension initiated on CA therapy between 1 January 2000 through 30 June 2002 were identified; the date the first CA prescription (CA-Rx) was filled in this period was labelled the index date. Inclusion required plan enrolment for 6 months pre- and 1 year post-index, no CA-Rx 6 months pre-index, and medication possession ratio >50% for 1 year post-index. Patients fell into either dihydropyridine or non-dihydropyridine study groups. Main outcome measures and results: For each group, costs (amounts allowed by plans, in US dollars; actual costs for 2000-2002) were calculated for resources attributable to DM/hypertension. A total of 5551 patients met eligibility criteria (NDCA = 1515; DCA = 4036). Most had been taking other antihypertensive I medications: 86% and 76% in the DCA and NDCA groups, respectively. The NDCA group had lower annual attributable costs than the DCA group ($US1637 [95% CI $US1479, $US1813] vs $US1989 [95% CI $US1823, $US2170]; p <0.004). A total of 313 medical charts were reviewed (DCA = 242, NDCA = 71). Both groups had similar pre-and post-index BP values; mean changes in systolic and diastolic BP were not statistically significant between groups. Only 22% of all patients attained the recommended systolic/diastolic BP goal of

AB - Background and objective: Calcium antagonists (CAs) from two classes - dihydropyridine and non-dihydropyridine (DCAs and NDCAs, respectively) - are important add-on agents in goal blood pressure (BP) attainment. This study compared drug regimens to which DCAs or NDCAs had been added; for each class, BP reduction and healthcare costs were evaluated in a diabetic hypertensive population. Design, setting and patients: This was a retrospective observational study using administrative claims data within two US health plans. Patients with diabetes mellitus (DM) and hypertension initiated on CA therapy between 1 January 2000 through 30 June 2002 were identified; the date the first CA prescription (CA-Rx) was filled in this period was labelled the index date. Inclusion required plan enrolment for 6 months pre- and 1 year post-index, no CA-Rx 6 months pre-index, and medication possession ratio >50% for 1 year post-index. Patients fell into either dihydropyridine or non-dihydropyridine study groups. Main outcome measures and results: For each group, costs (amounts allowed by plans, in US dollars; actual costs for 2000-2002) were calculated for resources attributable to DM/hypertension. A total of 5551 patients met eligibility criteria (NDCA = 1515; DCA = 4036). Most had been taking other antihypertensive I medications: 86% and 76% in the DCA and NDCA groups, respectively. The NDCA group had lower annual attributable costs than the DCA group ($US1637 [95% CI $US1479, $US1813] vs $US1989 [95% CI $US1823, $US2170]; p <0.004). A total of 313 medical charts were reviewed (DCA = 242, NDCA = 71). Both groups had similar pre-and post-index BP values; mean changes in systolic and diastolic BP were not statistically significant between groups. Only 22% of all patients attained the recommended systolic/diastolic BP goal of

UR - http://www.scopus.com/inward/record.url?scp=9644262339&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=9644262339&partnerID=8YFLogxK

U2 - 10.2165/00044011-200424110-00003

DO - 10.2165/00044011-200424110-00003

M3 - Article

VL - 24

SP - 641

EP - 649

JO - Clinical Drug Investigation

JF - Clinical Drug Investigation

SN - 1173-2563

IS - 11

ER -