Document Detail


Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus: an ADVANCE trial-based analysis.
MedLine Citation:
PMID:  20854235     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Medical journal of Australia     Volume:  193     ISSN:  0025-729X     ISO Abbreviation:  Med. J. Aust.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-21     Completed Date:  2010-10-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400714     Medline TA:  Med J Aust     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  320-4     Citation Subset:  IM    
Affiliation:
Clinical Epidemiology and Biostatistics, Bond University, Gold Coast, QLD, Australia. pglaszio@bond.edu.au
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00145925
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MeSH Terms
Descriptor/Qualifier:
Antihypertensive Agents / 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:
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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