Income differences in the type of antihypertensive medicines used in ambulatory settings in Finland: a register-based study.
Eur J Clin Pharmacol
; 71(10): 1263-70, 2015 Oct.
Article
in En
| MEDLINE
| ID: mdl-26227069
ABSTRACT
PURPOSE:
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.METHODS:
Personal 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.RESULTS:
Low 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).CONCLUSIONS:
Use of more expensive medicines contributed to higher costs among patients with higher incomes.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hypertension
/
Income
/
Antihypertensive Agents
Type of study:
Prognostic_studies
/
Risk_factors_studies
Aspects:
Determinantes_sociais_saude
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Eur J Clin Pharmacol
Year:
2015
Document type:
Article
Affiliation country:
Finland