Hypertensive patients treated with lacidipine: costs and outcomes. Resultsfrom a French study in general practice

Prescribing, conditions, safety of use and direct costs related to the intr oduction of lacidipine into the management of hypertension were evaluated ( between September 1993 and April 1994) in a non-controlled prospective obse rvation study. This study involved 14 277 subjects with mild or moderate es sential hypertension, enrolled by 3751 general practitioners. At the time o f enrollment, the mean age of this cohort, which consisted of 49.1% women, was 62 +/- 11.8 years with a high proportion of subjects aged over 65 years (41.3%). The vast majority of subjects were covered by a health insurance scheme (99.2%) and also had additional insurance cover (76.9%). Of these su bjects, 79.4% lived in an urban community with less than 100 000 inhabitant s. Hypertension, which had been present for a mean of 5.6 years, was alread y treated in 70.1% of them. At the end of 16 weeks of monitoring (mean obse rvation period, 114.8 days +/- 11.6), lacidipine was discontinued in 3.8% o f subjects and its dosage modified in 6.7%. The decision to discontinue was taken in 2.5% of subjects because of an adverse effect. The mean managemen t cost of these subjects was 1013.68 French francs (excluding hospitalizati on costs). These costs were broken down as follows: drug cost (68.6%, of wh ich 50.7% was for lacidipine); cost of office visits (24%); and cost of mon itoring investigations (7.4%). This mean cost rose to 1688.32 French francs when hospital costs were taken into account. Results of this cohort study involving 14 277 subjects confirmed the safety of lacidipine in the treatme nt of hypertension in general practice. The results also enabled calculatio n of the immediate costs of management of these hypertension sufferers, bas ed upon a unique and original approach. Such economic analyses are, in fact , most often based upon the modelling of clinical trials, known for the bia s which they introduce into everyday medical practice. I Hypertens 16 (supp l 9):S25-S30 (C) 1998 Lippincott Wiliams & Wilkins.