Trends in the Treatment of Hypertension within Managed Care Organizations: A National Survey of HMO Pharmacy Directors

Abstract

OBJECTIVE: To estimate the prevalence of changes to the initial treatment regimen of hypertensive patients in a managed care setting and to identify the factors having the most impact on the cost of treatment. Utilization patterns specifically related to angiotensin converting enzyme inhibitors (ACEls) and calcium channel blockers (CCBs) were looked at because of their particular cost impact. Secondary goals were to assess the types of changes made to therapy and to estimate the ACEI/CCB concomitancy rates (the number of patients receiving both medications at the same time) among these hypertensive patients, and the cost impact of these. DESIGN: In May 1995, a survey regarding the treatment of hypertension in managed care was faxed to a random sampling of pharmacy directors of 250 large (greater than 40,000 enrollees) managed care plans throughout the United States. A total of 29 pharmacy directors completed and returned the survey; all responses were included in the study analysis. The 29 plans represent...