Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Felodipine | Research article

Evidence for the effectiveness of anti-hypertensive medicines included on the Chinese National Reimbursement Drug List

Authors: Wenbin Liu, Lizheng Shi, Monika Sawhney, Xiaoli Gu, Yingyao Chen

Published in: BMC Health Services Research | Issue 1/2019

Login to get access

Abstract

Background

Evidence-based decision on drug list or formulary has been applied worldwide. Although the importance of scientific evidence was emphasized, the decision-making procedures for including medicines into the national reimbursement drug list were often challenged by their process opacity and relying on subjective expert opinion. This study aimed to explore and assess the evidence for the effectiveness of anti-hypertensive medicines included on the Chinese National Reimbursement Drug List (NRDL), and to provide recommendations for further improvement.

Methods

Three international evidence-based guidelines were selected to serve as reference criteria. The antihypertensive medicines included in NRDL of Urban Employee Basic Medical Insurance (UEBMI) were compared with recommended drugs in three international guidelines. Medicines recommended by at least two guidelines were considered to have sound evidence support for the effectiveness. Otherwise, published literature with high evidence grade, namely systematic review, meta-analysis and randomized controlled trial (RCT), were searched for further assessment. Medicines reported as fairly good effectiveness by literature with high evidence grade can be also considered having sound evidence for the effectiveness. Methodological quality of systematic review or meta-analysis was evaluated by AMSTAR scale and PRISMA statement. Literature quality of RCTs was assessed by Jadad scale.

Results

For the 97 antihypertensive medicines in NRDL, there were sound evidence supports for the effectiveness of 56 kinds of medicines. Specifically, twenty-six of them were supported by international evidence-based guidelines, twenty were supported by systematic review or meta-analysis and the other ten by RCT. However, for the rest 41 medicines, there is insufficient evidence for their effectiveness.

Conclusions

Some antihypertensive medicines in NRDL did not have sufficient evidence for their effectiveness. Further evaluation and revision were required. It is also recommended to standardize decision-making procedures for inclusion of medicines, set up high quality evidence database to timely provide sound evidence, and so on.
Appendix
Available only for authorised users
Literature
1.
Neumann PJ. Evidence-based and value-based formulary guidelines. Health Aff. 2004;23:124–34.CrossRef
2.
Yang Y, He P, Zou Y, Wang H, Wu Z. GRADE method and the application of it in the selection of essential drugs by WHO. China Pharm. 2011;22:2977–80.
3.
World Health Organization. The selection and use of essential medicines: report of the WHO expert committee. Geneva: World Health Organization; 2015.
4.
Wang L, Yuan Q, Cheng L, Li Y. Reflection on the selection and evaluation of essential drug list. China Pharm. 2010;21:1453–6.
5.
Fan L, Ma A. Discussion on the related questions about basic drug list selection. Health Economics Res. 2011;4:3–6.
6.
Tian X, Song Y, Zhang X. National Essential Medicine List and policy practice: a case study of China's health care reform. BMC Health Serv Res. 2012;12:401.PubMedPubMedCentralCrossRef
7.
Guo Y, Gan L, Xing H, Yuan HM. Analysis on the successful experience of selecting essential drugs in the other countries. Chinese Pharm Aff. 2013;27:353–5.
8.
Huang Y, Guo Y. Comparisons of the management models of domestic and foreign medical insurance covered medicine catalogs. Chinese Med Insur. 2013;12:68–70.
9.
10.
11.
National Institute for Health and Clinical Excellence. Hypertension: Clinical Management of Primary Hypertension in Adults. NICE Clinical Guideline 127. London: National Clinical Guideline Centre; 2011.
12.
Moher D, Liberati A, Tetzlaff J, Altman DG. The PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med. 2009;6(6):e1000097.PubMedPubMedCentralCrossRef
13.
Shea BJ, Grimshaw JM, Wells GA, et al. Development of AMSTAR: a measurement tool to assess the methodological quality of systematic reviews. BMC Med Res Methodol. 2007;7:10.PubMedPubMedCentralCrossRef
14.
Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials. 1996;17:1–12.PubMedCrossRef
15.
Zeng X, Liu J, Chen J, et al. Efficacy and safety of Fosinopril for mild to moderate essential hypertension: a systematic review. China Pharm. 2014;25:3372–6.
16.
Gasowski J, Wilkins A, Drzewoski J, et al. Short-term antihypertensive efficacy of perindopril according to clinical profile of 3,188 patients: a meta-analysis. Cardiol J. 2010;17(3):259–66.PubMed
17.
Chen S, Wang JJ, Wang QQ, et al. The effect of carvedilol and propranolol on portal hypertension in patients with cirrhosis: a meta-analysis. Patient Prefer Adherence. 2015;9:961–70.PubMedPubMedCentral
18.
Ke Z, Yao R, Chen Z, Fang C. Meta-analysis of the therapeutic efficacy and safety of doxazosin for mild to moderate essential hypertension. J Kunming Med Univ. 2015;36:28–32.
19.
Zhou X, Ma W. Efficacy of Urapidil in treatment for heart failure with hypertension: a Meta-analysis. Chinese J Cardiovasc Res. 2016;14:735–8.
20.
Li S, Qin L, Xu G. Effect of domestic Cilnidipine in the treatment of essential hypertension: a Meta analysis. Chinese Gen Pract. 2012;15:125–7.
21.
Dong W, Huang T, Zhou Y, Dong Y. Effects of sodium nitroprusside in the treatment of hypertensive emergency: a systematic review. China Pharm. 2012;23:3778–82.
22.
Hua Q. Meta-analysis of Lacidipine and amlodipine for essential hypertension. Front Med China. 2014;6:111–8.
23.
Jiang C, Qiu J, Xu Y, et al. Meta analysis on Nicardipine in the treatment of hypertensive emergency. Chinese J Drug Appl Monit. 2013;10:245–50.
24.
Ran Y, Wei L, Li D, Kuang F, Zhao C, Qian Y. The efficacy and tolerability of Lercanidipine and amlodipine for mild to moderate hypertension: Meta-analysis. Chongqing Med. 2015;44:4980–4.
25.
Du B, Qin L, Cui W. Meta analysis on Arotinolol in treatment of essential hypertension. J Jilin Univ. 2009;35:949–54.
26.
Zhao S, Yang W, Chen B. Meta-analysis of the efficacy and safety of benazepril vs. captopril in the treatment of primary hypertension. China Pharm. 2015;26:2524–6.
27.
Zhang Y, Shou S, Liu Y, Wang L. The efficacy of Enopril folic acid in treatment of H type hypertension. Shandong Med. 2015;55:54–6.
28.
Wu H, Xu G, Qin L. Meta-analysis on effectiveness and safety of irbesarten/hydrochlorothiazide combination therapy in treatment of essential hypertension. J Jilin Univ (Medicine Edition). 2011;37:517–22.
29.
Jin J, Yue Y, Jin Z, Wu F. Efficacy and safety of valsartan hydrochlorothiazide for primary hypertension: a Meta-analysis. Herald Med. 2013;32:394–7.
30.
Zhao Z, Chen Y. Efficacy and safety of amlodipine vs. Levamlodipine for mild to moderate hypertension: a systematic review. Eval Anal Drug-Use Hosp China. 2015;15:318–21.
31.
Chen Q, Ding D, Qin J. Efficacy of nimodipine combined with edaravone in treatment of hypertensive intracerebral hemorrhage: a meta-analysis. J Int Neurol Neurosurg. 2014;41:332–7.
32.
Wu Y, He L, Song Y, Hu Y. Compound anti-hypertensive tablets (no.0) for primary hypertension: a systematic review. China J Dis Control Prev. 2009;13:245–50.
33.
Magee LA, Namouz-Haddad S, Cao V, Koren G, Von DP. Labetalol for hypertension in pregnancy. Expert Opin Drug Saf. 2015;14(3):453–61.PubMedCrossRef
34.
Hu L, Liu S. Efficacy and safety of compound reserpine tablets for essential hypertension: systematic review. China Pharm. 2012;23:3219–23.
35.
Garnockjones KP. Esmolol: a review of its use in the short-term treatment of tachyarrhythmias and the short-term control of tachycardia and hypertension. Drugs. 2012;72(1):109–32.CrossRef
36.
Du X, Yin X, Zhang X. Comprehensive evaluation on amlodipine and Nitrendipine therapy for hypertension. Chin Hosp Pharm J. 2014;34:59–62.
37.
Zhang T, Wang X, Fan Q, Chen H, Hu Y. Efficacy and safety of amlodipine and Felodipine in the treatment of Chinese hypertension. PJCCPVD. 2013;21:37–40.
38.
Kandler MR, Mah GT, Tejani AM, Stabler SN, Salzwedel DM. Hydralazine for essential hypertension. Cochrane Database Syst Rev. 2010;65(8):CD004934.
39.
Shamon SD, Perez MI. Blood pressure lowering efficacy of reserpine for primary hypertension. Cochrane Database Syst Rev. 2009;202(4):CD007655.
40.
Cao J, Lei J, Gong T, Li L, Chen G, Chen W. Antihypertensive efficacy of amlodipine benapril in the treatment of mild to moderate hypertension: a randomized controlled trial. Hebei Med J. 2012;34(7):1013–4.
41.
Lu N, Lu K, Zhuang W, Xiang Q, Zhong Y, Ling J. The effectiveness and safety in treating unstable angina by metoprolol: a randomized controlled trial. Med Ind Inf. 2006;3(21):5–7.
42.
Zuo W, Wang C, Xue X. Porspective study on the effects of drug intervention is preventing the first bleeding of esophageal varices: a randomize controlled trial with propranolol, ISMN and spironolactone in combination. Chinese Hepatol. 2007;12(5):342–5.
43.
Jiang X, Wang J, Chen S, Zhu C. A randomized controlled clinical trial in the prevention of esophageal variceal bleeding. Chin J Gastroenterol. 2001;6(2):90–3.
44.
Huang G, Jia J, Zhen Y, et al. Multicentric prospective randomized controlled study of efficacy of mannitol, furosemide and albumin in reducing intracranial pressure in patients with severe brain injury. Chin J Trauma. 2008;24(8):680–3.
45.
Zheng W, Cao Y. Clinical randomized controlled trial on torasemide injection in treating patients with congestive heart failure and edema. Chin J Clin Pharmacol Ther. 2008;13(6):699–703.
46.
Lu Q, Zhao M, Rong Y, Liu X. Random case-control study of the effectiveness of Naftopidil and terazosin in treatment of hypertension. Chin J Pharmacoepidemiol. 2000;9(1):1–3.
47.
Liao Y. Randomized controlled trial on the efficacy of Olmesartan Medoxomil in remodeling left ventricular in treatment of morning surge of hypertension. Chin J Clin Ration Drug Use. 2014;7(4B):48–9.
48.
Tao B, Guo J, Chen S, et al. Comparison of two combination regimens in the treatment of mild to moderate essential hypertension. Chinese J New Drugs. 2006;15:550–3.
49.
Rokoss MJ, Teo KK. Ramipril in the treatment of vascular diseases. Expert Opin Pharmacother. 2005;6(11):1911–9.PubMedCrossRef
50.
Jiang X, Zhang Y, Wang R, et al. Comparison of imidapril and benazepril on central and peripheral blood pressures through pulse wave analysis. Chin J New Drugs Clin Rem. 2005;24:884–6.
51.
Collaborative Group of Diltiazem. A multicenter, randomized clinical trial of intravenous diltiazem in treatment of unstable angina. Chin J Cardiol. 2005;33:238–42.
52.
Wang X, Ke Y, Wu W, Zhou X, Jiang S. Efficacy of combination of enalapril/hydrochlorothiazide in Chinese patients with primary hypertension. Chin J New Drugs Clin Rem. 2006;25:759–62.
53.
Schiffrin EL. Remodeling of resistance arteries in human hypertension: effects of Cilazapril, an angiotensin-I-converting enzyme inhibitor. Cardiology. 2008;86(S1):16–22.
54.
Li Y, Yu J, Du L, et al. Exploration and practice of methods and processes of evidence-based rapid review on peer review of WHO EML application. Chin J Evid Based Med. 2015;15:1447–53.
55.
Chen Y, Banta D, Tang Z. Health technology assessment development in China. Int J Technol Assess Health Care. 2009;25(Suppl 1):S202–9.CrossRef
56.
Liu W, Shi L, Pong RW, et al. Differences in evaluating health technology assessment knowledge translation by researchers and policy-makers in China. Int J Technol Assess Health Care. 2014;30:612–20.PubMedCrossRef
57.
Cui M, Peng Y, Zhao J, Fang T. Comparative study of the health insurance directory entrance procedure of new drug domestic and overseas and the suggestion on the relevant policy in China. J Pharm Pract. 2011;29:226–8.
58.
Laupacis A. Economic evaluations in the Canadian common drug review. Pharmacoeconomics. 2006;24:1157.PubMedCrossRef
59.
Daniels N, Teagarden JR, Sabin JE. An ethical template for pharmacy benefits. Health Aff. 2003;22:125.CrossRef
Metadata
Title
Evidence for the effectiveness of anti-hypertensive medicines included on the Chinese National Reimbursement Drug List
Authors
Wenbin Liu
Lizheng Shi
Monika Sawhney
Xiaoli Gu
Yingyao Chen
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-3937-0

Other articles of this Issue 1/2019

BMC Health Services Research 1/2019 Go to the issue

Research article

Understanding determinants of acute stroke thrombolysis using the tailored implementation for chronic diseases framework: a qualitative study

Research article

The effect of psychosocial support on caregivers’ perceived criticism and emotional over-involvement of persons with dementia: an assessor-blinded randomized controlled trial

Research article

Efficiency of blood utilization in elective surgical patients

Research article

An administrative model for benchmarking hospitals on their 30-day sepsis mortality

Research article

Reasons for prolonged time for diagnostic workup for stage I-II lung cancer and estimated effect of applying an optimized pathway for diagnostic procedures

Research article

Person-centred, integrated and pro-active care for multi-morbid elderly with advanced care needs: a propensity score-matched controlled trial