To the Editor: The article by Nelson et al1 estimates Pharmaceutical Benefits Scheme and Repatriation Pharmaceutical Benefits Scheme (PBS/RPBS) savings if hypertensive patients on monotherapy were prescribed the agents recommended in guidelines; however, the analysis contains algebraic errors and insufficient sensitivity analyses. The question of excessive costs through the use of expensive agents for which there is no evidence of increased benefit for most patients is an important one, but the estimates of extent of overuse should be methodologically sound. The three main concerns we have with the paper's estimates are as follows:
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- 1 Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, NSW.
- 2 Department of General Practice, University of Adelaide, Adelaide, SA.
Correspondence: bewald@cceb.newcastle.edu.au
- 1. Nelson MR, McNeil JJ, Peeters A, et al. PBS/RPBS cost implications of trends and guideline recommendations in the pharmacological management of hypertension in Australia, 1994–1998. Med J Aust 2001; 174: 565-568.
- 2. PBS expenditure and prescriptions. January 2000 to December 2000. Canberra: Commonwealth Department of Health and Aged Care, 2001. Available at <http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health-pbs-general-pubs-pbbexp-pbdec00-index.htm>.
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