Changes in the Costs of Antihypertensive Medications in a Developing Country A Study in Mexico Comparing 1990 and 1996

Abstract

In developing countries, the cost of antihypertensive medications is one of the principal limiting factors when trying to treat patients with high blood pressure. To determine the changes in cost (in US dollars) of these medications and in the percentage of the minimum wage needed to purchase them, two cost studies (1990 and 1996) done in Mexico were compared. The yearly cost of a treatment with hydrochlorothiazide was US $13.80 in 1990; in 1996 it was US $10.92. Both figures represent 1.1% of the minimum wage that was in effect at the time. Propranolol hydrochloride cost US $50.52 for a year's treatment in 1990, and US $66.12 for the same in 1996. These figures represented, respectively, 4.2% and 6.7% of the minimum wage of 1990 and 1996. The annual cost for nifedipine was US $176.76 in 1990 (14.7% of the minimum wage) and US $242.16 in 1996 (24.8% of the minimum wage). The yearly cost of enalapril was US $233.04 in 1990 and US $433.20 in 1996; these costs represented, respectively, 19.4% and 44.2% of the minimum wage. The comparison of these two cost studies (1990 and 1996) shows why Mexico's population is finding it more difficult to purchase antihypertensive medications. Higher costs and reduced purchasing power seem to be the two principal factors causing this. This is probably affecting the population's health, as it is more difficult to control high blood pressure without proper treatment.

The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: a systematic review

“…Second, there is a gap relating to delivery setting: most studies concentrated on hospital care, with very few studies including economic aspects of CVD care in primary and community care. Only two studies estimated the costs of prevention, one in Mexico [32] and another in China [33]. Given the importance of prevention and service delivery at these levels, particularly as more innovative models are being rolled out at these levels in low-resource settings, there would be great value in exploring them as a matter of priority [9].…”

Availability, price and affordability of cardiovascular medicines: A comparison across 36 countries using WHO/HAI data

“…A Mexican study found that hydrochlorothiazide was the only treatment option that did not become less affordable between 1990 and 1996; 1.1% of the minimum wage was needed to pay for chronic treatment. Other CVD medicines increased up to threefold in price and treatment cost as much as 47% of the minimum wage [7]. A study performed in Ghana found that 93% of patients did not comply with their antihypertensive treatment regimen, 96% of which reported high medicine prices as the reason for not complying [8].…”

Antihypertensive drug utilization at health centres in a district of Istanbul

“…The treatment of hypertension and its cardiovascular sequel account for a significant proportion of the total expenditure for health care in many countries [1,2,[6][7][8]. Antihypertensive treatment should, in addition to lowering blood pressure, reduce the incidence of cardiovascular morbidity and mortality.…”