At a glance: Management of hypertension in adults

What’s the story? NICE has just published guidelines for the management of hypertension (high blood pressure) in adults.

What’s so interesting about them?

It has recommended the use of more generic products in the treatment ‘where appropriate’, to minimise cost.

Bad news for PROs promoting branded drugs, then?

Not according to Novartis, which produces hypertension megabrand Diovan. It points out that it is one of the world’s largest manufacturers of generics, too.

How will PROs react?

A switch to a greater concentration on hypertension generics certainly means PROs in that area will have to change their targets. They won’t need so much to influence doctors, who will be directed to prescribe a generic rather than a brand anyway. But they will need to ensure that pharmacists are on board with their product.

So where will they need to focus that activity?

Not so much on the benefits of the drug. Instead, British Generic Manufacturers Association director Warwick Smith suggests: ‘Any PR around a generic will be about levels of service rather than the product itself.’

Is this the only change we’ll see?

Probably not. At the same time, PROs working on branded hypertension products are likely to need to increase their work in other branded areas of treatment to claw back the market share that they are likely to lose on hypertension. PR spend will need to be redirected elsewhere.

What was NICE’s cost issue?

Anti-hypertension medicine prescriptions have increased five-fold in the past ten years. In 2001, around £840m went on prescriptions for them – that’s almost 15 per cent of the total annual cost of all primary care products.

But these drugs work?

The ABPI says hypertension-related hospital bed days in England have dropped, as a result, from 125,000 in 1991 to 91,000 by the end of 2002. They also contributed to a 22 per cent fall in the number of deaths from circulatory conditions during the last decade.

No one in the pharma industry is likely to be using the phrase ‘double-edged sword’ just yet.

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