PBS/RPBS cost implications of trends and guideline recommendations in the pharmacological management of hypertension in Australia, 1994-1998

Objectives: To determine the extent to which "current guidelines" for the m anagement of hypertension are reflected in the prescribing of antihypertens ive drugs in Australia over the period 1994-1998, and to examine the cost i mplications of actual and recommended prescribing patterns. Design: Federal Government and consumer cost estimates modelled on prescrib ing patterns and guideline recommendations over the period 1994-1998. Setting: Prescribing on Federal Government pharmaceutical schemes over the 1994-1998 period. Main outcome measures: Estimates of Pharmaceutical Benefits Scheme/Repatria tion Pharmaceutical Benefits Scheme cost changes in Australian dollar value s. Results: The implementation of current guidelines for patients with uncompl icated hypertension taking monotherapy alone could have reduced drug costs by $45-$108 million in 1998. Conclusions: Current prescribing patterns indicate that clinical practice h as pre-empted the results from clinical trials of newer, more expensive age nts and that clinicians' prescribing patterns do not closely reflect curren t recommendations.