Home' Australian Pharmacist : Australian Pharmacist January 2012 Contents 44 Australian Pharmacist January 2012 I ©Pharmaceutical Society of Australia Ltd.
VIPER combats hypertension
Researchers at Baker IDI Heart &
Diabetes Institute have released the
primary results from a national study --
VIPER-BP -- which trialled an aggressive
GP-led strategy to optimally manage
hypertension and further reduce
Australia's risk of stroke and heart
Professor Simon Stewart, Head of
Preventative Health at Baker IDI, and
Principal Investigator of the VIPER
BP Study1 said: 'For the first time in
Australia, this study was able to analyse
the efficacy of an aggressive new
first-line management strategy for
patients with high blood pressure in
primary care. The study revealed a more
intensive and structured approach --
including more frequent GP visits and
higher treatment doses -- can control
an individual's blood pressure much
more effectively than a more traditional
regime using fewer adjustments to
treatment and fewer GP visits.'
The VIPER-BP GP study investigators
were supported by case management
software developed by Baker IDI
which prompted the primary care
team (including practice nurses) to
more accurately identify and manage
cardiovascular risk in patients who
remained above their ideal blood
Professor Stewart said, 'Investigating
new ways to manage and reduce the
burden of high blood pressure is critical
in the face of rising health costs and
an ageing population. Without more
effective blood pressure management
Australia faces a 'perfect storm' of
cardiovascular disease risk factors with
a future health crisis of costly hospital
admissions and premature deaths.'
The results found:
• 36% of VIPER-BP patients achieved
their ideal (and therefore strict) blood
pressure target during six month
follow up compared to 28% of usual
• Overall, VIPER-BP patients were 25%
more likely to achieve their ideal
blood pressure goal.
• 63% of VIPER-BP patients achieved
the typical blood pressure target
during six month follow up
compared to 54% of 'usual' care
• As VIPER-BP patients achieved a
greater reduction in blood pressure,
they also reduced their risk of
future heart attack or stroke by 25%
compared to 16% in those patients
receiving 'usual GP care.
The VIPER-BP (Valsartan Intensified
Primary carE Reduction of Blood
Pressure) study recruited more than
2,300 Australians with high blood
pressure (hypertension) being
managed by more than 250 GPs
from around Australia. The study
was conducted by Baker IDI Heart
and Diabetes Institute with the
collaborative support of Novartis
Pharmaceuticals Australia Pty.
1. Stewart S, Carrington MJ, Swemmer C, et al. Optimising
management of hypertension in primary care: The
Valsartan Intensified Primary Care Reduction of Blood
Pressure (Viper-Bp) Study. Int J Cardiol 2011;153:317--22.
Australians access to
medicines better than NZ
A new study comparing access
to prescription medicines in New
Zealand with that in Australia
highlights alarming deficiencies in the
medicines system across the Tasman,
according to Medicines Australia chief
executive Dr Brendan Shaw.
The research, published in the
November issue of The New Zealand
Medical Journal, found that New
Zealanders have access to less than
half the number of prescription
medicines that Australians can access.
It also found that new medicines gain
regulatory approval on average nine
months sooner in Australia, and are
listed for Government subsidy almost
three years earlier.
Dr Shaw said the study illustrated the
dangers of doing health care on the
'This study provides clear and
compelling evidence why Australia
should not be emulating the New
Zealand model for subsidising
prescription medicines. It shows
that in the past 10 years New Zealand
patients have had access to less than
half the number of new medicines that
Australians have had.
'That is a very sobering statistic at a time
when some commentators are suggesting
that management of Australia's
Pharmaceutical Benefits Scheme should
be guided by the New Zealand model. The
evidence highlights the fact that there are
simply no subsidised medicines available
at all in New Zealand in a number of
therapeutic areas, and a disturbing lack of
treatment options in many others.
'This is a direct result of the policies and
processes adopted by New Zealand to
assess and reimburse medicines there.
That's what happens when you don't
invest in health care and your primary
focus is on cost-cutting. As the Australian
Government's decision to defer the
listing of medicines on the PBS earlier
this year shows, it's not a situation that
Australian patients either want or tolerate,
Dr Shaw said.
'It's time to "call it" for those
recommending Australia adopt New
Zealand's reimbursement policies.
For years we have heard suggestions
that Australia should run its medicines
reimbursement system like New Zealand.
Typically these advocates fail to mention
that New Zealanders do not have access
to many of the treatments available in
Australia, or have to wait three years
longer than Australians for the ones
they do have.
'This study proves the way New Zealand
has kept costs down is by denying
patients access to a range of treatments
that Australian patients and doctors take
for granted,' he said.
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