A Multicenter Retrospective Analysis on Clinical Effectiveness and Economic Assessment of Compound Reserpine and Hydrochlorothiazide Tablets (CRH) for Hypertension

BACKGROUND/OBJECTIVE: As the first generation of anti-hypertensive drug independently developed by China, Compound Reserpine and Hydrochlorothiazide Tablet (CRH) has been widely used in China for more than 40 years. However, limited studies are available for the performance of CRH for the treatment of hypertension in real-world setting in China. This study aimed to evaluate the comparative clinical effectiveness and treatment costs between CRH and three other anti-hypertensive agents that include, Triprolidine Hydrochloride (TH: Diovan), Amlodipine Besylate Tablet (ABT: Norvasc), and Nifedipine Tablets (NT: Procardin) in real-world clinical practice. METHODS: This was a multicentre, retrospective study conducted from May 2011 to May 2016 at four tertiary hospitals in China. Data from patients’ electronic medical records (EMR) were retrieved and analysed. A retrospective propensity score-matched analysis was used for three pairs of comparisons. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and overall blood pressure (BP) control rate on the 10th and 20th days after treatment were compared. The overall cost of treatment was analysed across groups. RESULTS: In three pairs of comparison, the patients who received CRH treatment obtained better blood pressure control at both day 10 and day 20. In addition, the patients who received CRH had lower total treatment costs compared with the other three anti-hypertensive drugs. Influential factor analysis showed that CRH is associated with a higher probability of BP control compared with the other three monotherapies in real-world clinical practice. CONCLUSION: The patients received CRH showed a higher overall BP control rate than the other three commonly prescribed anti-hypertensive drugs, which indicates that CRH has a better benefit in BP control for hypertensive patients. Also, the total cost for hypertension treatment is lower in CRH patients compared with the other three comparator drugs. These findings suggest that CRH could be an effective and cost-effective option for hypertensive patients.