COST EFFECTIVENESS OF LABETALOL VERSUS METHYLDOPA IN THE TREATMENT OF PREGNANCY INDUCED HYPERTENSION (PIH)
Pregnancy induced hypertension (PIH) complicates 5-8% pregnancies and accounts for thousands of maternal and foetal deaths each year. Antihypertensive drugs are often used to lower blood pressure with the aim of preventing its progression to adverse outcomes for the mother and the foetus. This study was carried out to evaluate the cost effectiveness of labetalol and methyldopa in treatment of PIH. Pregnant patients (20- 40 weeks gestational age) newly diagnosed with systolic blood pressure of ≥ 140 mmHg or diastolic blood pressure of ≥ 90 mmHg were included in the study. Patients were randomly divided into two groups of 50 cases each. Group I patients received labetalol 100 mg twice a day and Group II patients received methyldopa 250 mg thrice a day. For cost effectiveness analysis the maximum retail price of all the study drugs and the cost of baseline investigations was added, to give the total direct cost of each treatment. Effectiveness was calculated as a mean change in mean arterial pressure from baseline to the time of delivery. Incremental cost-effective ratio (ICER) was calculated for cost effectiveness analysis. A significant reduction in blood pressure was observed with both drugs (p<0.05). Labetalol was more costly. The difference in cost of treatment of both the groups was Rs. 627.28±268.43. The ICER was 351.81. Labetalol and methyldopa were both effective in lowering blood pressure in patients with PIH. Although labetalol was more effective and safe, methyldopa may be preferred in patients because of economic considerations.