Population consumption of antihypertensive and lipid-lowering drugs in the Russian Federation (SPARDEC)

Background. In the modern population, cardiovascular diseases associated with arterial hypertension and dyslipidemia predominate in the structure of non-communicable diseases, which justifies the need for long-term pharmacotherapy with antihypertensive and lipid-lowering drugs.

Objective: To study the consumption profile of antihypertensive and lipid-lowering drugs by the population of the Russian Federation (RF), which can be considered key cardiovascular drugs.

Material and methods. A long-term retrospective pharmacoepidemiological study was conducted. The statistics of pharmacy sales of these drug groups were analyzed, both as single-ingredient drugs and as fixed-dose combinations (FDCs), from 2017 to 2022 across 5,221 pharmacy organizations in 83 regions of the RF, out of a total of 70,400 pharmacy organizations registered in the country in 2022.

Results. It was found that the consumption of the following single-ingredient drugs predominates: angiotensin-converting enzyme inhibitors (31.9%), β-blockers (22.7%), calcium channel blockers (10.5%), and diuretics (10.3%). Among single-ingredient drugs, the leading positions are held by amlodipine (13.6%), enalapril (11.6%), and indapamide (9.7%). Among FDCs, the most common are “losartan + hydrochlorothiazide” (20.6%), “perindopril + indapamide” (15.4%), “amlodipine + indapamide + perindopril” (9.1%). Average cost of 1 defined daily dose (DDD) was 2.8 rubles for diuretics, 3.2 rubles for calcium channel blockers, 4.0 rubles for angiotensin-converting enzyme inhibitors, 8.0 rubles for sartans, 10.0 rubles for β-blockers, 9.0 rubles for statins. The cost of 1 DDD for FDCs is significantly higher – ranging from 15 to 40 rubles – which may be a key factor contributing to their extremely low consumption (7.1% for antihypertensive FDCs and 6.9% for statin FDCs), inconsistent with current clinical guideline recommendations.

Conclusion. The structure of pharmacy sales of key cardiological drugs from 2017 to 2022 has remained conservative, with a predominance of single-ingredient medications and a lack of alignment with current cardiology trends toward increased use of FDCs and statins. To date, no domestically produced polypill formulations combining an antihypertensive agent and a statin exist on the Russian market, and the share of imported polypill multitarget drugs remains extremely low.

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