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Prescribing Patterns in Chronic Diseases, Evaluation of 1326 Medical Prescriptions from the Area of Mount Lebanon

Georges Choueiry, Souheil Hallit and Pascale Salameh

Objective: to analyze the cost and type of pharmaceuticals prescribed to treat chronic diseases in Lebanon, particularly hypertension and diabetes.

Methods: 1326 medical prescriptions were collected from 3 different pharmacies in Mount Lebanon during the period July 2015 and February 2017. Costs were analyzed using the list of drug prices of March 21, 2017 provided by the ministry of public health. We also included the composition and therapeutic class of each medication.

Results: Out of 168 hypertension prescriptions, 50% included beta-blockers, 43.5% angiotensin receptor blockers, 41.7% diuretics and 40.5% calcium channel blockers. The most prescribed hypertensive medication was bisoprolol (35.1%), followed by hydrochlorothiazide (30%) which was also the most prescribed ingredient in association. Diuretics and beta-blockers were the least expensive (with medians of 5.4 and 6.6 USD respectively), while ACE inhibitors and angiotensin receptor blockers were the most expensive ones (with medians of 19.8 and 25.4 USD respectively). The most common association encountered was angiotensin receptor blockers and diuretics, present in 23.5% of total hypertension prescriptions.

Metformin was the most prescribed ingredient (91.3% of total diabetes prescriptions) and the most prescribed in association, followed glimepiride (26.1%), vildagliptin (18.8%) and insulin (8.7%). The most prescribed classes in association for treating diabetes were biguanides and gliptins (36.2%) followed by biguanides and sulfonylureas (30.4%). The median prescription cost of hypertensive medications was 22 USD, lipid disorders (26.1 USD), anxiety/depression (11.1 USD) and diabetes (18.7 USD).

Conclusion: the prescribing patterns in our sample were in accordance with the guidelines of hypertension and diabetes management. The current range of drug prices in the Lebanese market makes these treatments affordable for patients of all socioeconomical classes.