Issue 21 - August 2007 - ARBs - NHS Brighton and Hove City ...
Issue 21 - August 2007 - ARBs - NHS Brighton and Hove City ...
Issue 21 - August 2007 - ARBs - NHS Brighton and Hove City ...
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A few small changes could benefit your prescribing costs!<br />
Prescribing in line with current choice of Angiotensin Receptor Blockers (ARB) could<br />
make all the difference to your prescribing budget<br />
In line with the information sent out to practices on how your practice is doing so far in this<br />
year’s Prescribing Incentive Scheme, this month’s quick wins shows a price comparison of the<br />
different costs of Angiotensin Receptor Blockers (<strong>ARBs</strong>). The ARB of choice is<br />
C<strong>and</strong>esartan <strong>and</strong> Irbesartan – in line with the BSUH formulary. In the latest quarter (Apr-<br />
June <strong>2007</strong>) the PCT spent £264,412 on ARB, 35% of which was accounted for by Losartan.<br />
Losartan 25mg<br />
Losartan 50mg<br />
Losartan 100mg<br />
C<strong>and</strong>esartan 2mg<br />
C<strong>and</strong>esartan 4mg<br />
C<strong>and</strong>esartan 8mg<br />
C<strong>and</strong>esartan 16mg<br />
Valsartan 40mg<br />
Valsartan 80mg<br />
Valsartan 160mg<br />
Irbesartan 75mg<br />
Irbesartan 150mg<br />
Irbesartan 300mg<br />
Eprosartan 300mg<br />
Eprosartan 400mg<br />
Eprosartan 600mg<br />
Olmesartan 10mg<br />
Olmesartan 20mg<br />
Olmesartan 40mg<br />
Telmisartan 20mg<br />
Telmisartan 40mg<br />
Telmisartan 80mg<br />
Price comparison of ARB (Drug Tariff Sept 07)<br />
£8.15<br />
£7.89<br />
£9.89<br />
£10.29<br />
£11.63<br />
£10.95<br />
£11.96<br />
£11.34<br />
£11.34<br />
£12.80<br />
£12.72<br />
£12.57<br />
£12.95<br />
£14.76<br />
£14.31<br />
£14.18<br />
£16.18<br />
£16.44<br />
£16.91<br />
£18.09<br />
£17.50<br />
£<strong>21</strong>.66<br />
£0.00 £5.00 £10.00 £15.00 £20.00 £25.00<br />
Please see the table <strong>and</strong> charts overleaf for cost comparison of ARB against equivalent dose of<br />
C<strong>and</strong>esartan.<br />
If you would like help or guidance on these quick wins please do not hesitate to contact<br />
me – Jemma Brunton – Specialist Pharmacy Technician on 01273 545348 or email<br />
jemma.brunton@bhcpct.nhs.uk
Original Drug<br />
Original<br />
Dose<br />
Equivalent Dose<br />
Cost for 28/7<br />
(£)* Lisinopril Ramipril C<strong>and</strong>esartan<br />
Losartan 25mg 18.09 2.5mg 1.25mg 2mg<br />
50mg 12.8 5mg 2.5mg/5mg 4mg<br />
100mg 16.18 10-20mg 5mg/10mg 8-16mg<br />
C<strong>and</strong>esartan 2mg 11.96 2.5mg 1.25mg<br />
4mg 8.15 5mg 1.25mg<br />
8mg 9.89 10mg 2.5mg/5mg<br />
16mg 12.72 20mg 5mg/10mg<br />
Valsartan 40mg 14.76 2.5mg 1.25mg 2mg<br />
80mg 16.44 5mg 2.5mg/5mg 4mg<br />
160mg <strong>21</strong>.66 10-20mg 5mg/10mg 8-16mg<br />
Irbesartan 75mg 10.29 2.5mg 1.25mg 2mg<br />
150mg 12.57 5mg 2.5mg/5mg 4mg<br />
300mg 16.91 10-20mg 5mg/10mg 8-16mg<br />
Eprosartan 300mg 11.63 2.5mg 1.25mg 2mg<br />
400mg 7.89 5mg 2.5mg/5mg 4mg<br />
600mg 14.31 10-20mg 5mg/10mg 8-16mg<br />
Olmesartan 10mg 10.95 2.5mg 1.25mg 2mg<br />
20mg 12.95 5mg 2.5mg/5mg 4mg<br />
40mg 17.5 10-20mg 5mg/10mg 8-16mg<br />
Telmisartan 20mg 11.34 2.5mg 1.25mg 2mg<br />
40mg 11.34 5mg 2.5mg/5mg 4mg<br />
80mg 14.18 10-20mg 5mg/10mg 8-16mg<br />
These figures are based on appropriate doses for elderly <strong>and</strong> st<strong>and</strong>ard initiation doses from Prodigy (accessed<br />
23.08.07) <strong>and</strong> current prescribing information from BNF 53 Mar <strong>2007</strong>. NB Local opinion suggests that dose of<br />
C<strong>and</strong>esartan required to reach targets is usually in excess of 8mg<br />
*Drug Tariff Sept <strong>2007</strong><br />
Losartan 25mg<br />
Losartan 50mg<br />
Losartan 100mg<br />
Valsartan 40mg<br />
Valsartan 80mg<br />
Valsartan 160mg<br />
Irbesartan 75mg<br />
Irbesartan 150mg<br />
Irbesartan 300mg<br />
Eprosartan 300mg<br />
Eprosartan 400mg<br />
Eprosartan 600mg<br />
Olmesartan 10mg<br />
Olmesartan 20mg<br />
Olmesartan 40mg<br />
Telmisartan 20mg<br />
Telmisartan 40mg<br />
Telmisartan 80mg<br />
Chart of cost comparison of ARB vs equivalent dose of C<strong>and</strong>esartan<br />
£0.00 £5.00 £10.00 £15.00 £20.00 £25.00<br />
Cost of ARB Cost of C<strong>and</strong>esartan at equivalent dose (2)