Trends in Antihypertensive Use among Privately insured hypertensive Clients in Ghana

Abstract To describe the patterns of antihypertensive medicines (AHM) in a selected national population in Ghana. We analysed the claims data for all privately-insured patients in Ghana over three years to 2018. We examined the medicines, class and dose by time, gender and age, and generic status. We estimate the use in Defined Daily Dose (DDD) per 1000 population per day. Classes of AHM prescribed were CCB, ARB, ACEI, diuretics and BB. Amlodipine, nifedipine, losartan, lisinopril, and bendroflumethiazide accounted for 74% of all use. The most widely used single CCB was amlodipine 3.92 DDD/1,000 population/day in 2016, 3.92 DDD/1,000 population/day in 2017, and 4.92 DDD/1,000 population/day in 2018. In those aged 51-60 years, use of CCB in women (74.0 DDD/1,000 population/day) was almost twice that of men (38.3 DDD/1,000 population/day). The top ten medicines accounted for 93% of all single medicine products in 2018. Most single medicine products was generic (76.5% in 2016; 79.9% in 2017 and 83.1% in 2018) whiles most fixed combination products were branded (73.0% in 2016; 89.7% in 2017 and 91.3% in 2018). The patterns of AHM use are clinically expected although the Ghana Standard Treatment guidelines are not directive about lines of treatment.