Pharmacoeconomic comparison of losartan and amlodipine in patients of hypertension in a tertiary care teaching hospital


  • Iram Shaifali Department of Pharmacology, Rohilkhand Medical College and Hospital, Bareilly 243006, Uttar Pradesh, India
  • H. K. Singh Department of Pharmacology, Rohilkhand Medical College and Hospital, Bareilly 243006, Uttar Pradesh, India



Amlodipine, Cost-effectiveness, Hypertension, Losartan, Pharmacoeconomics


Background: To conduct a pharmacoeconomic comparison (cost-effectiveness analysis) and to evaluate the overall safety and efficacy of Losartan and Amlodipine in reducing the Mean blood pressure per mm Hg in hypertensive patients.

Methods: This was a prospective, randomized, open label, observational analysis of cost-effectiveness; into compare the cost of Losartan 50mg and Amlodipine 5mg in hypertensive patients using either of the two drugs. A total of 80 newly diagnosed drug naïve hypertensive patients were considered for the comparison, of which 40 patients were prescribed Losartan and the other 40 were prescribed Amlodipine as per the recommended dosage. Based on the data, statistical analysis was carried out using SPSS Software Version 21.

Results: The two drugs were found to be equi-effective in reducing the blood pressure to the target goal, at their respective equivalent doses Moreover, the cost of reducing 1 mm of Hg mean blood pressure with Losartan was 103.42 INR, whereas that of Amlodipine was 57.11 INR. Hence the cost incurred in treating elevated BP was markedly lower with the Amlodipine group as compared to the Losartan group.

Conclusions: This pharmacoeconomic analysis shows that Amlodipine is more cost-effective as compared to Losartan when the cost per mm Hg reduction in mean blood pressure is considered. Hence in India, where the cost of drug is a significant deterrant to patient compliance, cost-effective therapy of chronic disease like hypertension is of prime importance.


Victor RG. Systemic Hypertension: Mechanisms and Diagnosis. In: Bonow RO, Mann DL, Zipes DP, Libby P (Eds.). Braunwald’s heart disease: a textbook of cardiovascular medicine. 9th ed. Philadelphia: WB Saunders; Elsevier; 2011:935-954.

Kearney PM, Whelton M, Reynolds K. Global burden of hypertension: analysis of worldwide data. Lancet. 2005;365:217-23.

Lawes CMM, Hoorn SV, Rodgers A. Global burden of blood-pressure related disease. Lancet. 2008;371:1513-8.

He J, Gu D, Chen J. Premature deaths attributable to blood pressure in China: a prospective cohort study. Lancet. 2009;374(9703):1765-72.

Rodrigo M, Premranjan P, Richard W. Diabetes and Hypertension. Natural Clinical Practice. 2007;3(10).

Whitworth JA. World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens. 2003;21:1983-92.

Barreras A, Turner CG. Angiotensin II receptor blockers. Proc (Bayl Univ Med Cent). 2003;16:123-6.

Renin DRH, Angiotensin. In: Brunton LL, Chabner BA, Knollmann BC editors. Goodman and Gilman’s The Pharmacological Basis of Therapeutics. 12th ed. New York: McGraw Hills; 2011:738-739.

Chen WX, Tan X. A review of the utilization of oral calcium channel blockers. Curr Pharm Today (Chinese). 2009;19:31-3.

Antihypertensive Drugs. In: Tripathi KD (Ed.) Essentials of Medical Pharmacology. 7th ed. Jaypee Brothers Medical Publishers; 2013:562-563.

Wilson TW, Lacourcière Y, Barnes CC. The antihypertensive efficacy of Losartan and Amlodipine assessed with office and ambulatory blood pressure monitoring. CMAJ. 1998;159:469-76.

Phillips RA, Kloner RA, Grimm RH, Weinberger M. The effects of Amlodipine compared to Losartan in patients with mild to moderately severe Hypertension. J Clin Hypertens. 2003;5:17-23.

Minami J, Abe C, Akashiba A, Takahashi T, Kameda T, Ishimitsu T, et al. Long-Term Efficacy of Combination Therapy With Losartan and Low-Dose Hydrochlorothiazide in Patients With Uncontrolled Hypertension. Int Heart J. 2007;48:177-86.

Nelsen LM, Himmelberger DU, Morrison A. Qualityof-life questionnaire for patients taking antihypertensive medication. Clin Ther. 1999;21(10):1771-87.

Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, et al. American Heart Association Advocacy Coordinating Committee, Stroke Council, Council on Cardiovascular Radiology and Intervention, Council on Clinical Cardiology, Council on Epidemiology and Prevention, Council on Arteriosclerosis, Thrombosis and Vascular Biology, et al. Forecasting the future of cardiovascular disease in the united states: A policy statement from the American heart association. Circulation. 2011;123:933-44.

Ormond BA, Spillman BC, Waidmann TA, Caswell KJ, Tereshchenko B. Potential national and state medical care savings from primary disease prevention. Am J Public Health. 2011;101:157-64.

Pittman DG, Tao Z, Chen W, Stettin GD. Antihypertensive medication adherence and subsequent healthcare utilization and costs. Am J Manag Care. 2010;16:568-76.

Athanasakis K, Souliotis K, Tountas Y, Yfantopoulos J, Kyriopoulos J, Hatzakis A. A Short-Term Cost-Effectiveness Analysis of Hypertension Treatment in Greece Hellenic J Cardiol. 2014;55:197-203.

Rosana LGT, I Giovanio VS, I Katia CO, I Ota´vio B, De´cio J. An economic evaluation of antihypertensive therapies based on clinical trials. CLINICS. 2012;67(1):41-8.

Diener HC, Bogousslavsky J, Brass LM. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebo-controlled trial. Lancet. 2004;364(9431):331-7.

Saju AP, Edakkarayil AC, Maheswari E, Gurudev KC. Prescribing pattern and cost effectiveness analysis of antihypertensive drugs in chronic kidney disease patients. EJPMR. 2016;3(1):219-25.

Mullins CD, Blak BT, Akhras KS. Comparing cost-effectiveness analyses of anti-hypertensive drug therapy for decision making: mission impossible? Value Health. 2002;5:359-71.

Yanfei Wu, Zhou Q, Xuan J, Li M, Zelt S, Huang Y et al. A Cost-Effectiveness Analysis between Amlodipine and Angiotensin II Receptor Blockers in Stroke and Myocardial Infarction Prevention among Hypertension Patients in China. Value in health regional issues. 2013;2:75-80.

de Portu S, Mantovani LG. Amlodipine: a pharmacoeconomic review. J Med Econ. 2009 Mar;12(1):60-8.

Wang JG, Li Y, Franklin SS. Prevention of stroke and myocardial infarction by Amlodipine and angiotensin receptor blockers: a quantitative overview. Hypertension. 2007;50(1):181-8.




How to Cite

Shaifali, I., & Singh, H. K. (2017). Pharmacoeconomic comparison of losartan and amlodipine in patients of hypertension in a tertiary care teaching hospital. International Journal of Basic & Clinical Pharmacology, 6(3), 552–558.



Original Research Articles