Abstract 232: Medication Cost Savings Using an On-line Drug Discount Program

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Satish Munigala ◽  
Margaret Brandon ◽  
Zackary D Goff ◽  
Richard Sagall ◽  
Paul J Hauptman
Keyword(s):  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Financial Burden ◽  
Cost Savings ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Medication Cost ◽  
Converting Enzyme Inhibitors ◽  
Entire Study ◽  
Assistance Programs

Objective: To evaluate the frequency of drug discount card utilization and to estimate cost savings associated with heart failure (HF) medication prescriptions. Methods: We conducted a retrospective study of all HF prescriptions filled through the NeedyMeds.org drug discount card program nationwide, from January 2009 to December 2016. We evaluated the frequency of drug discount card prescriptions (across pharmacy types, pharmacy location, by prescriber specialty and by drug class) and calculated cost savings (average per drug discount card and total program dollars saved) for entire study period and for each year (from 2009 to 2016). Findings: A total of 381,347 prescriptions for medications that can be used for HF with drug discount cards were identified during the study period (83.7% at national, 5.7% at regional and 9.8% at local pharmacies). Most prescriptions were filled at urban locations (89.1% in urban clusters, 7.6% in urbanized areas) and in ZIP-codes with lower median household income (65.5%). Angiotensin-converting enzyme inhibitors and selected angiotensin receptor blockers were the most prescribed drugs with discount cards (44.1%) followed by beta blockers (27.5%), diuretics (21.5%), and mineralocorticoid receptor agonists (3.9%). The number of HF prescriptions with drug discount cards increased from 2577 in 2009 to 64,750 in 2016. Increase in the number of prescriptions was also noted for all drug classes from 2009 to 2016. Overall 224,049 prescriptions for HF medications (59% of the total) benefited from the program resulting in total savings of $4,739,204 with a median cost saving of $9.30 (41.5%) per prescription. Conclusion: Use of a drug discount program resulted in cost savings on HF prescription medications (approximately $9 in savings per prescription) compared to the original cost charged by pharmacies. While these drug assistance programs may reduce financial burden, continued efforts should be made to improve adherence to medications and for better outcomes.

scholarly journals Role of antihypertensive drugs in the treatment of migraine

2015 ◽  
Vol 156 (5) ◽  
pp. 179-185 ◽  
Author(s):  
Gergely Fehér ◽  
Gabriella Pusch
Keyword(s):  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Migraine Prevention ◽  
Angiotensin Receptor ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

The treatment of migraine depends on the frequency, severity and concomitant diseases. There are several specific drugs developed for migraine prevention in addition to the additive antimigraine effects of some other non-specific drugs. The aim of this literature-based review is to summarize the possible antimigraine properties of different antihypertensive agents (beta-blockers, calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, etc.) focusing on the possible side effects (avoidance of beta blockers in the absence of heart disease, possible antiparkinson effect of calcium channel blockers, additive effect of drugs modifying the renin-angiotensin system activity, etc.). Current evidence supports the use of angiotensin converting enzyme inhibitors (mainly lisinopril) and angiotensin receptor blockers (mainly candesartan) for long-term migraine prevention and blood pressure control. Long-term beta-blocker treatment should be avoided in the absence of ischemic heart disease due to possible unfavourable cardiovascular effects. Orv. Hetil., 2015, 156(5), 179–185.

scholarly journals Combined RAAS and NEP Inhibition

2019 ◽  
Vol 17 ◽  
Author(s):  
Giuseppe Vergaro ◽  
Marco Metra
Keyword(s):  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Receptor ◽  
Mineralocorticoid Receptor Antagonists ◽  
Converting Enzyme Inhibitors ◽  
Drug Classes ◽  
Receptor Blockers ◽  
Nep Inhibition

The neurohormonal model of HF has provided the rationale for the use of drug classes blocking the effectors of both the RAAS and SNS at different sites, including angiotensin-converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), mineralocorticoid receptor antagonists (MRA), and beta-blockers. Combined NEP and ACE blockade although unsuccessful with omapatrilat in the OVERTURE trial, found success with sacubitril/valsartan in the Paradigm-HF trial. The results of PARADIGM-HF trial represent one of the most significant breakthroughs in the management of HF of the last decade, representing a shift from neurohomonal antagonism to neurohormonal modulation.

scholarly journals Heart failure medication after a first hospital admission and risk of heart failure readmission, focus on beta-blockers and renin-angiotensin-aldosterone system medication: A retrospective cohort study in linked databases

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244231
Author(s):  
Willemien J. Kruik-Kollöffel ◽  
Job van der Palen ◽  
Carine J. M. Doggen ◽  
Marissa C. van Maaren ◽  
H. Joost Kruik ◽  
...  
Keyword(s):  
Heart Failure ◽  
Hospital Admission ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Post Discharge ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers ◽  
Unselected Group

Background This study assessed the association between heart failure (HF) medication (angiotensin-converting-enzyme inhibitors (ACEI)/angiotensin-receptor blockers (ARB), beta-blockers (BB), mineralocorticoid-receptor antagonists (MRA) and diuretics) and HF readmissions in a real-world unselected group of patients after a first hospital admission for HF. Furthermore we analysed readmission rates for ACEI versus ARB and for carvedilol versus β1-selective BB and we investigated the effect of HF medication in relation to time since discharge. Methods and findings Medication at discharge was determined with dispensing data from the Dutch PHARMO Database Network including 22,476 patients with HF between 2001 and 2015. After adjustment for age, gender, number of medications and year of admission no associations were found for users versus non-users of ACEI/ARB (hazard ratio, HR = 1.01; 95%CI 0.96–1.06), BB (HR = 1.00; 95%CI 0.95–1.05) and readmissions. The risk of readmission for patients prescribed MRA (HR = 1.11; 95%CI 1.05–1.16) or diuretics (HR = 1.17; 95%CI 1.09–1.25) was higher than for non-users. The HR for ARB relative to ACEI was 1.04 (95%CI 0.97–1.12) and for carvedilol relative to β1-selective BB 1.33 (95%CI 1.20–1.46). Post-hoc analyses showed a protective effect shortly after discharge for most medications. For example one month post discharge the HR for ACEI/ARB was 0.77 (95%CI 0.69–0.86). Although we did try to adjust for confounding by indication, probably residual confounding is still present. Conclusions Patients who were prescribed carvedilol have a higher or at least a similar risk of HF readmission compared to β1-selective BB. This study showed that all groups of HF medication -some more pronounced than others- were more effective immediately following discharge.

Abstract P184: Reduction in Atherosclerotic Events Through Use of Aggressive Risk Factor Reduction Medications in an Outpatient Cardiology Practice

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Hoang M Lai ◽  
Anthony D Mercando ◽  
Wilbert S Aronow ◽  
Phoenix Kalen ◽  
Harit V Desai ◽  
...  
Keyword(s):  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Medication Usage ◽  
Converting Enzyme Inhibitors ◽  
Treatment Protocols ◽  
Receptor Blockers ◽  
Event Rates

Background : Although atherosclerotic disease cannot be cured, risk of recurrent events can be reduced by application of evidence based treatment protocols involving aspirin, beta blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and statin medications. Purpose : To compare atherosclerosis event rates in a patient population treated before and after the development of aggressive risk factor reduction treatment protocols. Methods : A retrospective chart review study of patients presenting for follow-up treatment of coronary artery disease in a community cardiology practice, comparing event rates and medication usage in a 2 year treatment period prior to 2002 to a 2 year treatment period in 2005-2008. Standard care was provided in both the early treatment era and the later era by board-certified cardiologists in a 7 physician suburban cardiology practice. Medication usage was compared in both treatment eras. The primary outcome was a composite event rate of myocardial infarction, cerebrovascular events (transient ischemic attacks or cerebrovascular accident), and coronary interventions (percutaneous or surgical). The outcome measures were identified before data collection or analysis were performed. Results : 357 patients were studied for 2 year periods in each era, with a total follow-up duration of 12.1 (± 3.5) years. There were 132 composite events in 104 patients (29.1%) in the early era compared to 40 events in 33 patients (9.2%) in the later era (p< 0.0001). This result was driven mostly by a reduction in percutaneous and surgical coronary interventions between the 2 eras. From the early to the late eras, there was an increase in the use of beta blockers (66% to 83%, p<0.0001), angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (34% to 80%, p<0.0001), and statins (40% to 90%, p<0.0001); although aspirin usage did not increase, it was prescribed frequently in both eras (78% and 79%). Conclusions : Application of aggressive evidence-based medication protocols for treatment of atherosclerosis is associated with a significant decrease in events or need for coronary intervention.

Abstract 3783: Antihypertensive Medications in the Department of Veterans Affairs (VA) 1999–2006

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Julio R Lopez ◽  
Sonya Wong ◽  
Joy L Meier ◽  
Fran Cunningham ◽  
David Siegel
Keyword(s):  
Antihypertensive Medication ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Medication Use ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Steady Increase ◽  
Channel Blockers ◽  
Antihypertensive Medications ◽  
Converting Enzyme Inhibitors

Objective: To evaluate national antihypertensive medication use we collected data from 2003–2006 and compared it to previously collected data from 1999 –2002. We examine the cost implications of shifts in antihypertensive medications prescribed. Methods: National VA pharmacy data were used to determine the use of beta blockers (BB), calcium channel blockers (CCB), thiazide diuretics (TD) alone or with K sparing diuretics, angiotensin converting enzyme inhibitors (ACEI), angiotensin receptor blockers (ARB), and combinations of the aforementioned classes for 2003–2006. Total number of treatment days, determined from days supply of the prescription, was used to determine patterns of use over time. Results: Antihypertensive medication use in the VA represented more than 1.5 billion days in 2006 and increased 2.5 fold from the 577 million estimated for 1999. ACEI were most commonly used, representing 31.8% and 31.7% of treatment days in 1999 and 2006, respectively. In the ACEI class lisinopril is the most commonly used drug. Increases in use from 1999 to 2006 were 21.2% to 25.2% for BB, 14.4% to 17.8% for TD, and 1.2% to 5.2% for ARB. Decreases in use from 1999 to 2006 were 26.7% to 17.6% for CCB. The decline in CCB was inversely correlated to the increase in BB or TD (p<0.001). Shifts in medication use are estimated to save the VA $33 million annually. Conclusions: ACEI remain the most prescribed antihypertensive drug class in the VA, followed by BB, TD, CCB, and ARBs. TD use shows a slow steady increase while CCB use continues to decline. These findings suggest that VA has increasing adherence to JNC7 and VA HTN guidelines.

Cardioprotective drugs

2017 ◽  
Author(s):  
Johan De Sutter ◽  
Miguel Mendes ◽  
Oscar H. Franco
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Black People ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Stable Coronary Artery Disease ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Channel Blockers ◽  
Converting Enzyme Inhibitors

Cardioprotective drugs are important in the treatment of patients at risk for or with documented cardiovascular disease. Beta-blockers are indicated after acute coronary syndromes, stable coronary artery disease, heart failure, and arrhythmias. Angiotensin-converting enzyme inhibitors (ACEi) are important in congestive heart failure, stable angina, post-acute myocardial infarction, and secondary prevention after any event or revascularization. Angiotensin receptor blockers are mainly alternative drugs for the same indications in case of intolerance to ACEi. Calcium channel blockers are first line medication for patients with isolated systolic hypertension, black people, and during pregnancy, in the presence of intermittent claudication, asymptomatic atherosclerosis, or metabolic syndrome. A polypill is a combination pill in which multiple medications effective in the prevention of cardiovascular disease (for example statins, antihypertensives, and aspirin) are put together in a single pill.

scholarly journals Az akut myocardialis infarctus főbb hazai ellátási jellemzői 2005–2009 között a EuroHOPE kutatás eredményei alapján

2016 ◽  
Vol 157 (41) ◽  
pp. 1626-1634
Author(s):  
Éva Belicza ◽  
Judit Lám ◽  
István Kósa
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Enzyme Inhibitors ◽  
Beta Blockers ◽  
Angiotensin Receptor Blockers ◽  
Intervention Group ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Acceptable Result ◽  
Converting Enzyme Inhibitors ◽  
St Elevation

Introduction: The EuroHOPE research developed the standardised methodology of the analysis of the healthcare process. Aim: The aims of the authors were to analyze the care of acute myocardial infarction in Hungary and to compare the results to those of the partner countries. Method: The authors analyzed the application of early and late invasive interventions, medication purchase, and mortality. The results were compared to Finnish, Norwegian, Italian, Scottish and Swedish data. Results: By the end of the observed period, approximately half of the patients received early treatment, which is an internationally acceptable result. Purchase of statins, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers was around 90%, but the application of beta-blockers has decreased for unknown reason. The mortality rate has improved, but it was still significantly worse than that in the partnering countries. One year mortality in the early intervention group was 1.5 times higher, and in the late intervention group was 2 times higher than the second worst results. Conclusions: The causal analysis concerning the professional activities, operational practices, and the role of the patients in the observed period is highly recommended. For more detailed analysis it is necessary to follow the trends and to separate the diagnoses of ST- elevation and non-ST-elevation acute myocardial infarction. Orv. Hetil., 2016, 157(41), 1626–1634.

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