Wellmark Blue Cross and Blue Shield report examines local beta-blocker use

Wellmark Blue Cross and Blue Shield report examines local beta-blocker use Usage of beta-blockers by individuals in the greater Vermillion area is below state and national benchmarks, according to a study by Wellmark Blue Cross and Blue Shield, published this week in The Wellmark Report.

This is the first in a series of special reports focusing on prescription drug usage � the fastest growing segment of health care expenditures. This report spotlights beta-blockers, which help reduce high blood pressure and the risk of heart attack, heart disease and stroke.

"Beta-blocker usage in the greater Vermillion area is 35 per 1,000, as contrasted with the national rate of 45 per 1,000 and a South Dakota rate of 40 per 1,000, while generic usage is at 80 percent, as compared to the statewide rate of 72 percent," said Dr. Sheila Riggs, vice president, health care measurement and reporting, Wellmark Blue Cross and Blue Shield, and director of The Wellmark Report.

"Deadwood, Gregory, Martin, Rapid City and Winner have the lowest beta-blocker usage among South Dakota communities, with a range of 21 to 29 per 1,000," Riggs added. "Bowdle, Britton, Chamberlain, Tyndall and Wagner have the highest usage, ranging from 56 to 64 per 1,000. We're not suggesting that low or high usage is right or wrong, but that we need to look more closely at the high level of variability across the state and what that means for our standards of care.

"One in four U.S. adults has high blood pressure, but many go undiagnosed or untreated, which is why we recommend individuals have their blood pressure checked annually," said Wellmark Blue Cross and Blue Shield Chief Medical Officer Dr. Dale Andringa. "It is vital that individuals know their blood pressure, and if it is 140/90 or higher � for an extended period of time � they should be under a doctor's care.

"The first step is to evaluate the appropriateness of lifestyle changes � weight reduction, increased exercise and improved diet, smoking cessation and salt restriction. Beta-blockers, when combined with diuretics, are an appropriate and cost effective first-line category of drugs for the treatment of hypertension, when lifestyle changes are not enough to maintain proper blood pressure control," Andringa said. "We want people to be treated with beta-blockers when there is a medical need."

The proprietary beta-blocker usage information comes from the Wellmark Blue Cross and Blue Shield database of prescription drug claims submitted on behalf of approximately 55,000 South Dakota residents and 485,000 Iowa residents between the ages of 18 and 65 who had prescription drug coverage through Wellmark Blue Cross and Blue Shield health plans in 2001. The database is sufficiently large enough to enable this report to draw a statistically valid profile of the health status of the privately insured populations of South Dakota and Iowa.

In 2001, Wellmark members spent $1.9 million on 55,851 prescriptions for brand-name beta-blocker medications and $1.56 million on 182,063 prescriptions for generic beta-blockers, out of a total of $260 million in prescription drug claims. Last year, in Iowa and South Dakota, Wellmark Blue Cross and Blue Shield paid $51 million in claims for members under the age of 65 who received care for a heart attack or stroke.

"There are many brand name and generic beta-blockers on the market," said Wellmark Director of Pharmacy Lee Ding. "In most cases, the generic version of the drug is just as effective as the brand name, only less costly. That is something we all should be concerned about, given the dramatic increase in prescription drug prices. We recommend that individuals check with their physicians or pharmacists about whether a generic equivalent is right for their situation."

The report shows that the communities of Clear Lake, Gregory, Miller, Philip and Sisseton have the highest usage of generic beta-blockers, with a range of 93 to 98 percent. In comparison, Canton, Chamberlain, Dell Rapids, Parkston and Viborg have the lowest usage of generic beta-blockers, with a range of 47 to 59 percent.

Five years ago, Wellmark premiered The Wellmark Report. The report is a nationally recognized health status study offering comparisons of health care trends and utilization in Iowa and South Dakota, pinpointing communities in both states with the highest or lowest prevalence or utilization.

Because prescription drugs are the fastest growing component of health care expenditures, this year Wellmark Blue Cross and Blue Shield has expanded The Wellmark Report to evaluate prescription drug use.

A series of special reports will profile a specific drug category and include the utilization rate of that drug category in both Iowa and South Dakota.

For additional information, including beta-blocker usage by community area and the towns included in each community area, go to http://www.wellmark.com/health_improvement/reports/well mark_report.htm.

Wellmark, Inc., does business as Wellmark Blue Cross and Blue Shield of Iowa. Wellmark and its subsidiaries and affiliated companies, including Wellmark Blue Cross and Blue Shield of South Dakota, insure or pay health benefit claims for approximately 1.7 million persons. Wellmark Blue Cross and Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association.

For more information regarding Wellmark Blue Cross and Blue Shield, go online at www.wellmark.com.

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