The 2018 recall of key angiotensin II receptor blockers (ARBs) due to carcinogenic contaminants has left a substantial impact on patients managing hypertension, heart failure, and chronic kidney disease. This large-scale drug shortage saw medications like valsartan, losartan, and irbesartan being pulled from the market, forcing patients to seek alternative treatments.
Impact on Medication Adherence and Healthcare Visits
Researchers utilized an extensive integrated dataset combining claims and electronic health records to assess the repercussions of the ARB recalls. By comparing ARB users with those taking similar non-recalled drugs such as ACE inhibitors, the study examined changes in medication adherence, blood pressure control, and healthcare utilization over an 18-month period following the recalls.
Significant Shifts in Medication Usage
The findings revealed a dramatic increase in medication switching post-recall, especially within the first 90 days after valsartan was recalled. Over half of valsartan users transitioned to different medications, showcasing a 195.9% relative increase in switches compared to those on non-recalled drugs. Additionally, patients experienced more frequent medication gaps exceeding 30 days, which became noticeable after approximately 15 months.
• Immediate surge in medication switches post-recall, particularly for valsartan
• Over half of valsartan users changed medications within 18 months
• Slight increase in medication gaps and cardiovascular-related acute care visits over time
Although overall clinical outcomes remained largely stable, the study noted minor yet notable increases in medication inconsistencies and acute cardiovascular events among certain patient groups. These effects highlight the challenges faced by patients during drug shortages and the critical importance of available alternatives within the same drug class.
The ARB recalls of 2018 underscored the vulnerability of hypertension management to drug supply disruptions. While the availability of alternative medications mitigated severe adverse outcomes for most patients, the increased rate of medication switching and gaps indicates areas needing improvement in healthcare response strategies. Ensuring a robust supply chain and enhancing patient support during such recalls can further minimize the impact on patient health and adherence to treatment regimens.
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