Patterns and associated health services costs of antihypertensive drug modifications.

This study sought to identify patterns of antihypertensive drug modifications in initial drug therapy as well as to examine the effect of modifications on costs. The study population included adults who initiated antihypertensive drug therapy during 12 months of therapy. Approximately three-fourths of study participants had a change in therapy within the first 12 months of treatment. Discontinuation (57.1%) of antihypertensive drug treatment was the most prevalent modification type, followed by titrations (14.6%). Initiating treatment with fixed-dose combinations was associated with the lowest likelihood of a nondiscontinuation modification (12.5%); the use of 2 separate drugs was associated with the least likelihood of complete discontinuation (28.7%). The presence of therapy changes was associated with increased health services costs in the first 12 months of antihypertensive drug therapy. Clinicians and payers should be aware of the association between starting specific antihypertensive treatment regimens and the likelihood of changes in medication and changing costs.