Comparison of the Value of Hypertension Drug Therapies and Their Market Performance

Abstract

PURPOSE
The sales and marketing of pharmaceutical products is a highly complex and multifactorial process. In addition to the patient, as the final consumer we shall never ignore the prescribing physician and the financing healthcare system, not to mention the regulations and the interlacements of corporate interests and positions. The question arises: What is the basis for selecting the appropriate drug therapy within a given indication? From the authors’ point of view if an active pharmaceutical ingredient (API) can be proved to be better scientifically, it has to have a positive impact on its market performance. This approach is in accordance with the principles of the evidence based medicine.

METHODS
In order to achieve a valuable comparison between drug therapies we have to live with further assumptions for the analysis. For a competitive landscape, every API compared has to be available in generic form for a relatively long period. The APIs should be actors of the prescription drug market, and should be prescribed for the same indications with the same route of action. To meet the mentioned assumptions, the family of antihypertensive drugs seemed to be an appropriate choice. Amongst the hypertension drugs we can find groups with different method of action, and several chemical entities within each group. These chemical entities are available in generic form for ages and in most of the countries of the world. In order to define the active pharmaceutical ingredients’ clinical rank, we collected high-quality comparative clinical studies (most of them are meta-analyses). We weighted the studies in accordance with the international recommendations to define our own ranks. As a next step we validated our ranks with doctors with relevant professional experience.

RESULTS
The clinical ranks were compared against market data on the performance of the different API therapies available on the US, German and Hungarian market. The results confirm the inconsistency of the literature. In the article we collect the most important factors that influence the prescribing process, and we give a short explanation of the possible causes of the anomalies. The given explanations are based on interviews with pharmaceutical experts from the USA, Germany and Hungary.

IMPLICATIONS
The recent study can be considered a methodological preparation and introduction for our further investigations.