A Formulary Analysis of Angiotensin II Antagonists in a UK Teaching Hospital

Objective: To develop a method of value analysis which would facilitate an objective comparison of available angiotensin II antagonists as antihypertensive agents, in order to provide an adaptable framework which would allow for future developments in new product introduction and changes in evidence base. Methods: Six angiotensin II antagonists were available for review at the time of the study: candesartan, eprosartan, irbesartan, losartan, telmisartan and valsartan. A team comprised of a cardiologist, a physician and a pharmacist conducted the evaluation. A nine-point selection criteria set was developed as a comparison framework. Each criterion was assigned a relative weighted value by the panel. Each drug product was systematically evaluated against each criterion to generate a series of product-criterion scores. Results: A total score for each product was derived by combining product-criterion scores and the respective weighted values. The results obtained were presented to the hospital's Drug and Therapeutics committee. Analysis of these scores ranked losartan highest (707), followed by valsartan (611) and candesartan (610). The agents most recently introduced on to the UK market scored the lowest. Conclusion: The formulary analysis was accepted by the therapeutics committee as a viable method of comparison and consequently the previous formulary selections of candesartan and losartan was deemed to be justified.