gms | German Medical Science

16th Annual Meeting of the German Drug Utilisation Research Group (GAA)

Gesellschaft für Arzneimittelforschung und Arzneimittelepidemiologie

19.11. - 20.11.2009, Berlin

Prescription patterns of drugs inhibiting the renin-angiotensin-aldosterone-system (RAAS) in the Federal State of Saxony – an analysis of the AOK health insurance service database in the years 2003 and 2004

Meeting Abstract

  • Melanie Kosa - Institute of Clinical Pharmacology, Medical Faculty, TU Dresden, Germany
  • Joachim Siegert - Institute of Clinical Pharmacology, Medical Faculty, TU Dresden, Germany
  • Beate Brecht - Institute of Clinical Pharmacology, Medical Faculty, TU Dresden, Germany
  • Jane Schröder - Institute of Clinical Pharmacology, Medical Faculty, TU Dresden, Germany
  • Ulf Maywald - AOK Plus, Dresden, Germany
  • Wilhelm Kirch - Institute of Clinical Pharmacology, Medical Faculty, TU Dresden, Germany
  • corresponding author Christoph Schindler - Institute of Clinical Pharmacology, Medical Faculty, TU Dresden, Germany

Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie e.V. (GAA). 16. Jahrestagung der Gesellschaft für Arzneimittelanwendungsforschung und Arzneimittelepidemiologie. Berlin, 19.-20.11.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09gaa20

DOI: 10.3205/09gaa20, URN: urn:nbn:de:0183-09gaa203

Published: November 5, 2009

© 2009 Kosa et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Background and aim: RAAS-blockade plays a pivotal role not only in the management of arterial hypertension but also in congestive heart failure, post myocardial infarction and nephropathy with albuminuria, especially in diabetic patients. However, so far little is known about the physicians’ prescription preferences of ACE-inhibitors (ACE-Is) and angiotensin-receptor-blockers (ARBs) in Germany on a regional level.

Material and method: We systematically analyzed the prescription patterns of ACE-inhibitors (ACE-Is) and Angiotensin receptor blockers (ARBs) in the federal state of Saxony, Germany, using the database of the largest health insurance service (AOK Krankenkasse) in Saxony for the years 2003 and 2004. Prescriptions for all insured individuals who received either an ACE-I or an ARB were analyzed. Data were evaluated quarterly and an average was calculated for each calendar year.

Results: A total of 301.510 patients were treated with a RAAS blocking agent (either ACE-I or ARB) in 2003 and 304.272 patients in 2004. In 2003, 74.6% of these patients were treated with an ACE-I, 23.1% with an ARB and 2.3% received double RAAS-blockade with an ACE-I and an ARB. In 2004, 72.6% of patients received an ACE-I, 25.1% an ARB and 2.3% of patients were on ACE-I-ARB-combination treatment. Of all ACE-I prescriptions, captopril (23.1%), enalapril (21.9%) and lisinopril (19.7%) were the most frequently prescribed drugs in 2003. Valsartan (27.3%), candesartan (24.2%) and losartan (18.5%) were the most frequently administered ARBs in 2003. In 2004, ramipril (24.3%), enalapril (21.5%) and captopril (19.9%) were the most commonly used ACE-Is. The pattern of ARB prescriptions in 2004 was similar to the previous year: valsartan (27.0%), candesartan (24.1%) and losartan (15.3%). Much less RAAS blocking agents were prescribed in the first quarter of each year compared to the fourth quarter, an observation which might be linked to economic reasons.

Conclusions: The number of prescriptions for ACE-Is was three times higher compared to ARBs. Dual RAAS-blockade with ACE-I – ARB combination treatment was uncommonly prescribed which is in line with limited evidence of benefit from double RAAS inhibition.