The goal of this study was to compare the direct costs associated with the prescription of thiazide diuretics, bêta-receptor blockers (bêta-blockers), angiotensin converting enzyme inhibitors (ACEI), alpha-receptor blockers (alpha-blockers), and calcium channel blockers (CCB) for the prevention of stroke, myocardial infarction (MI) and premature death in uncomplicated hypertension.
We performed a cost-minimization analysis based on numbers-needed-to-treat (NNT) derived from the metaanalysis of 15 major clinical trials of hypertension treatment, and the average wholesale prices of both the most commonly prescribed and the least expensive drugs in each class.
The inclusion criteria for clinical trials were that they be randomized, controlled trials of drug therapy of uncomplicated mild-to-moderate hypertension with stroke, MI, or death as endpoints.
The wholesale drug costs and the total direct outpatient treatment costs to prevent a stroke, MI or death among middle-aged and elderly hypertensives were our outcome measures.
The estimated wholesale drug acquisition cost to prevent one major event (MI or stroke or death) ranged from $4730 to $346,236 among middle-aged patients, and from $1595 to $116,754 in the elderly ; generic diuretic or bêta-blocker therapy was more economical than treatment with an ACEI, alpha-blocker, or CCB.
The associated 5-year NNT was 86 for middle-aged patients and 29 for elderly patients. (...)
Mots-clés Pascal : Hypertension artérielle, Diurétique, Peptidyl-dipeptidase A, Peptidyl-dipeptidases, Peptidases, Hydrolases, Enzyme, Inhibiteur enzyme, Bloquant bêta-adrénergique, Antagoniste calcium, Analyse coût, Economie santé, Chimiothérapie, Traitement, Homme, Etude comparative, Antihypertenseur, Appareil circulatoire pathologie, Angiotensin converting enzyme
Mots-clés Pascal anglais : Hypertension, Diuretic, Peptidyl-dipeptidase A, Peptidyl-dipeptidases, Peptidases, Hydrolases, Enzyme, Enzyme inhibitor, Beta blocking agent, Calcium antagonist, Cost analysis, Health economy, Chemotherapy, Treatment, Human, Comparative study, Antihypertensive agent, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0307452
Code Inist : 002B02F05. Création : 27/11/1998.