Current studies in pharmacoeconomics

Conclusions

Although the management of hypertension has received prolonged pharmacoeconomic attention, the major questions beyond the advisability of active intervention, remain unresolved. It is still unclear whether the purported advantages of newer agents outweigh their greater treatment costs, particularly in the face of unproven effects on cardiovascular risks. The existing published analyses lack a broad perspective, either in terms of the interventions considered or of the aspects that are addressed. It is impossible, therefore, to reach any conclusion regarding the economic support for one choice of treatment over another. What little has been studied of the intensity of treatment suggest sthat more is better, but this is at present restricted to special populations or situations. Whether it will prove to be so in more general situations remains to be seen.

Studies that appropriately address realistic choices in the more difficult-to-study natural environment of actual practice are urgently needed. Until then, physicians an policy makers will be left with a puzzling, inconsistent, economic appraisal.