Physicians Often Prescribe More Expensive Hypertension Medications, Study Finds
Physicians often prescribe more costly, newer medicines to treat high blood pressure in place of drugs recommended in medical guidelines, according to a study in Wednesday's Journal of the American Medical Association, the AP/Las Vegas Sun reports. Researchers Michael Fischer and Jerry Avron of Harvard's Brigham and Women's Hospital and colleagues studied Pennsylvania's drug-assistance program, through which more than 133,000 patients filled more than two million prescriptions for hypertension drugs in 2001 at a cost of $48.5 million to the state. The study found that almost 40% of the patients were prescribed medicines other than those recommended by medical guidelines. According to the study, calcium channel blockers, which cost an average of $33.39 per prescription, accounted for the most spending, nearly $17 million in 2001. According to the AP/Sun, the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure recommends diuretics called thiazides -- the least expensive drug at a cost of $5.33 per prescription -- as the first-line treatment in cases of hypertension without other complications. According to the study, if patients had been prescribed thiazides, the state would have saved $11.6 million in 2001. Further, the nation could reduce its prescription drug spending by about $1.2 billion through better prescribing of hypertension treatments, according to the study. While researchers did not focus on the reason that physicians prescribe more costly drugs, "they speculated that aggressive drug company advertising may be one reason," the AP/Sun reports. Fischer said that advertising is "a really important area for further study," adding, "There's advertising both to consumers and physicians." Dr. Hoangmai Pham, a senior health researcher at the Center for Studying Health System Change who was not involved in the study, said that "advertising is only part of the story," adding that "patients often believe the best care is the costliest and push for more expensive treatments," the AP/Sun reports (Fidler, AP/Las Vegas Sun, 4/20). An abstract of the study is available online.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.