BACKGROUND Antihypertensive medication use patterns have likely been influenced by changing costs and accessibility over the past 3 decades. This study examines the relationships between patent exclusivity loss, medication costs, and national health policies on antihypertensive medication use. METHODS Using 1996 to 2021 Medical Expenditure Panel Survey data of US adults with hypertension taking at least 1 antihypertensive medication, we conducted a cross-sectional analysis. We explored the associations between patent exclusivity loss, per-pill costs, and Medicare Part D enactment on medication use over time, focusing on the most commonly used medications (lisinopril, amlodipine, losartan, hydrochlorothiazide, and metoprolol). RESULTS The unweighted sample comprised 50 095 US adults (mean age, 62 years; 53% female). The survey-weighted number of adults taking antihypertensive medications increased from 22 million (95% CIs, 20-23 million) to 55 million (95% CI, 51-60 million) between 1996 and 2021. Loss of patent exclusivity led to increased medication fills, notably for lisinopril, amlodipine, and losartan, which all exhibited within-class dominance. However, per-pill cost decreases coinciding with Medicare Part D did not increase the number of individuals treated or the use of specific antihypertensive medications or classes. CONCLUSIONS The increase in antihypertensive medication use over the past decades highlights the significant impact of loss of patent exclusivity on the uptake in the use of specific medications. These findings underscore the complexity of factors influencing medication use, beyond cost reductions alone, and suggest that policies need to consider multiple facets to effectively improve antihypertensive medication accessibility and utilization.

中文翻译：

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1996 年至 2021 年美国抗高血压药物的使用和成本模式。


背景 在过去 3 年中，抗高血压药物的使用模式可能受到不断变化的成本和可及性的影响。本研究考察了专利独占权丧失、药物成本和国家抗高血压药物使用卫生政策之间的关系。方法 使用 1996 年至 2021 年至少服用 1 种抗高血压药物的美国成人高血压患者的医疗支出小组调查数据，我们进行了横断面分析。我们探讨了专利排他性损失、每片药丸成本和 Medicare D 部分颁布的药物使用随时间推移之间的关联，重点关注最常用的药物（赖诺普利、氨氯地平、氯沙坦、氢氯噻嗪和美托洛尔）。结果 未加权样本包括 50 095 名美国成年人 （平均年龄 62 岁;53% 为女性）。1996 年至 2021 年期间，服用抗高血压药物的成年人的调查加权人数从 2200 万（95% CI，20-2300 万）增加到 5500 万（95% CI，51-6000 万）。专利排他性的丧失导致药物填充量增加，尤其是赖诺普利、氨氯地平和氯沙坦，它们都表现出类内主导地位。然而，与 Medicare D 部分同时发生的每片药成本降低并没有增加接受治疗的人数或特定抗高血压药物或类别的使用。结论 过去几十年抗高血压药物使用量的增加凸显了专利排他权丧失对特定药物使用接受的重大影响。这些发现强调了影响药物使用的因素的复杂性，而不仅仅是降低成本，并表明政策需要考虑多个方面，以有效提高抗高血压药物的可及性和利用率。