A Pharmacoeconomic Analysis On the Usage of Combination of Telmisartan & Hydrochlorothiazide Versus Combination of Losartan & Hydrochlorothiazide in Treatment of Patients with Stage II Hypertension

Background: Hypertension is one of the common ailments causing significant morbidity and mortality all over the world and also in our country. Hypertension is defined as a clinical entity where systolic blood pressure is over 130 mm of Hg and diastolic blood pressure over 90 mm of Hg. The prevalence is about 27.6% in rural and 33.8% in urban India. Stage II hyper tension refers to systolic pressure more than 160 mm of Hg and diastolic more than 100 mm of Hg. Pharmacoeconomics is analysis of cost of treatment in a health care system. It includes cost of drug therapy and other health services. Cost includes direct medical cost, indirect cost, intangible cost and direct nonmedical cost. Aim: To analyse the pharmacoeconomics in two groups, where group A received combination of Telmisartan & hydrochlorothiazide and group B received combination of Losartan & hydrochlorothiazide in patients with stage II hypertension. Objectives: To assess the Incremental cost effective ratio (ICER) of two different treatments, that is telmisartan &hydrochlorothiazide and losartan & hydrochlorothiazide using cost effective analysis. The other objective is to determine quality of life (QoL)using EQ-5D scale among stage II hypertension in both the groups stated above. Material and Methods: A prospective and randomized study was done in SVRRGG Hospital, Tirupati on 210 patients with stage II hypertension. ICER is also calculated by comparing the cost of treatment and QALY (quality adjusted life year). QoL is calculated using EQ-5D scale (likert scale) Result: ICER was found to be 736 rupees/QALY. The p value for all the parameters of EQ-5D was calculated which is as follows, that is mobility(p=1.0), self care (p=0.86) usual activities (p=0.60) pain & discomfort(p=0.87) and anxiety & depression (p=0.74). Conclusion: ICER values indicate treatment with group A was more pharmacoeconomical than group B. The p value of the all 5 parameters of QOL was less than 0.5, which was statistically nonsignificant.