| Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus: an ADVANCE trial-based analysis. | |
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MedLine Citation:
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PMID: 20854235 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To determine the cost-effectiveness of routine administration, irrespective of blood pressure (BP), of a fixed-dose combination of perindopril and indapamide to patients with type 2 diabetes mellitus. DESIGN, SETTING AND PARTICIPANTS: Prospective cost-effectiveness analysis within the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial, an international, multicentre, randomised controlled trial of 11,140 participants with type 2 diabetes randomly allocated to receive perindopril plus indapamide (4 mg-1.25 mg/day) or placebo. MAIN OUTCOME MEASURES: Health-related quality-of-life measured by the EuroQol-5D, resource utilisation, and cost-effectiveness (cost per death averted at 4.3 years' average follow-up, and estimated cost per life-year gained, by extrapolation). RESULTS: The mean health-related quality-of-life score of survivors was 0.80 (on a 0-1 scale [death to full health]), with no difference between treatment groups. Active treatment reduced hospital admissions for coronary heart disease and coronary revascularisation by 5%. For the Australian participants, perindopril-indapamide cost A$1368 per patient during the trial period, but reduced total hospitalisation costs by A$410 and other medication costs (mainly other BP-lowering drugs) by A$332. The absolute reduction in all-cause mortality for the active treatment group was 1.1%, giving a cost per life saved of A$49,200. Lifetime extrapolation gave an estimated cost per life-year saved of A$10,040 (discounted at 5% per year). CONCLUSION: The combination of perindopril and indapamide in patients with type 2 diabetes appears to be cost-effective. TRIAL REGISTRATION: United States National Library of Medicine NCT00145925. |
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Authors:
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Paul P Glasziou; Philip Clarke; Jan Alexander; Mohana Rajmokan; Elaine Beller; Mark Woodward; John Chalmers; Neil Poulter; Anushka Patel |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The Medical journal of Australia Volume: 193 ISSN: 0025-729X ISO Abbreviation: Med. J. Aust. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-21 Completed Date: 2010-10-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0400714 Medline TA: Med J Aust Country: Australia |
Other Details:
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Languages: eng Pagination: 320-4 Citation Subset: IM |
Affiliation:
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Clinical Epidemiology and Biostatistics, Bond University, Gold Coast, QLD, Australia. pglaszio@bond.edu.au |
| Data Bank Information | |
Bank Name/Acc. No.:
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ClinicalTrials.gov/NCT00145925 |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Antihypertensive Agents
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administration & dosage*,
economics Australia Blood Pressure / drug effects Cost-Benefit Analysis Diabetic Angiopathies / economics, mortality, prevention & control* Hospital Costs Humans Hypertension / economics, prevention & control* Indapamide / administration & dosage*, economics Life Expectancy Perindopril / administration & dosage*, economics Quality of Life |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 26807-65-8/Indapamide; 82834-16-0/Perindopril |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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