A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Income differences in the type of antihypertensive medicines used in ambulatory settings in Finland: a register-based study
Tekijät: Mirva H, Johanna T, Jussi T, Aaltonen K
Julkaisuvuosi: 2015
Lehti:European Journal of Clinical Pharmacology
Tietokannassa oleva lehden nimiEuropean journal of clinical pharmacology
Lehden akronyymi: Eur J Clin Pharmacol
Vuosikerta: 71
Numero: 10
Aloitussivu: 1263
Lopetussivu: 70
Sivujen määrä: 8
ISSN: 0031-6970
eISSN: 1432-1041
DOI: https://doi.org/10.1007/s00228-015-1911-2
Tiivistelmä
The objective of this study was to explore income differences in the prevalence of moderate-to-severe hypertension, and among patients, in the use and costs of medicines.\nPersonal income was used to classify ≥25-year-old population in quintiles (QI-QV). Patients (N = 497,560) with moderate-to-severe hypertension were identified using special refund entitlements. Medicine use and costs derived from prescription register. Direct standardisation and multivariate regression were used to adjust for demographics and comorbidities.\nLow income was associated with higher prevalence of moderate-to-severe hypertension (overall 13%). After adjusting for age, gender, residence, diabetes and coronary heart disease, nearly all patients purchased at least one antihypertensive medicine (93 vs. 96% in QI and QV). Differences in the purchased quantities were small (mean estimates 1028 vs. 1054 defined daily doses (DDDs)/patient/year in QIV and QI). High-income patients were more likely to use angiotensin receptor blockers (37 vs. 54% in QI and QV). Low-income patients were more likely to use beta-blockers (59 vs. 49%, respectively) and ACE inhibitors (35 vs. 28%, respectively). Higher income was associated with higher annual out-of-pocket costs (mean €66 vs. €71 in QI and QV) and reimbursements (€144 vs. €163, respectively).\nUse of more expensive medicines contributed to higher costs among patients with higher incomes.\nPURPOSE\nMETHODS\nRESULTS\nCONCLUSIONS
The objective of this study was to explore income differences in the prevalence of moderate-to-severe hypertension, and among patients, in the use and costs of medicines.\nPersonal income was used to classify ≥25-year-old population in quintiles (QI-QV). Patients (N = 497,560) with moderate-to-severe hypertension were identified using special refund entitlements. Medicine use and costs derived from prescription register. Direct standardisation and multivariate regression were used to adjust for demographics and comorbidities.\nLow income was associated with higher prevalence of moderate-to-severe hypertension (overall 13%). After adjusting for age, gender, residence, diabetes and coronary heart disease, nearly all patients purchased at least one antihypertensive medicine (93 vs. 96% in QI and QV). Differences in the purchased quantities were small (mean estimates 1028 vs. 1054 defined daily doses (DDDs)/patient/year in QIV and QI). High-income patients were more likely to use angiotensin receptor blockers (37 vs. 54% in QI and QV). Low-income patients were more likely to use beta-blockers (59 vs. 49%, respectively) and ACE inhibitors (35 vs. 28%, respectively). Higher income was associated with higher annual out-of-pocket costs (mean €66 vs. €71 in QI and QV) and reimbursements (€144 vs. €163, respectively).\nUse of more expensive medicines contributed to higher costs among patients with higher incomes.\nPURPOSE\nMETHODS\nRESULTS\nCONCLUSIONS
Ladattava julkaisu This is an electronic reprint of the original article. |  |
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