gms | German Medical Science

Background and aim: Data show an increase in outpatient utilization of antihypertensives since 1996 within Germany's statutory health insurance.

Comparison of the observed utilisation of antihypertensive drugs with the expected needs based on the assumptions of prevalence and medical guidelines from 2006 to 2007.

Material and method: Using the ATC classification, antihypertensives (C02), diuretics (C03), beta blockers (C07), calcium channel blockers (C08) and agents acting on the renin-angiotensin system (C09) were included in the analysis. It was based on consumption data on 237 m prescriptions in 2007 (2006: 232 m). The quantities of defined daily doses (DDD) were converted into number of patients which could have been treated with these quantities. Based on epidemiological data derived from the German health survey and medical guidelines, the number of patients which need to be treated was estimated. This figure was compared to the number of patients that could have been treated with the prescribed amount of drugs.

Results: Consumption of antihypertensives increased from 10,679 m DDD in 2006 to 11,490 m DDD in 2007. With the consumed amount of antihypertensives, it would have been possible to treat 20.1 m patients in the year 2007 (2006: 18.7 m). According to the prevalence of antihypertension and medical guidelines 24 m patients need to be treated in Germany. Therefore, 3 m patients are lacking treatment.

Conclusion: There are various opinions as to why the utilisation of antihypertensives is increasing (e.g. wastage). With our study we can not disprove the validity of these theses, but in 2007 there is a gap between needs and prescribed drugs which reflect undersupply. Obviously, doctors are closing the gap in health care by prescribing more antihypertensives as decreasing prices (by a total of EUR –228 m) bring relief to their drug budgets. Additionally, reduced co-payments for antihypertensive drugs lead to higher compliance of patients.