Document Detail


Health economic implications of irbesartan plus conventional antihypertensive medications versus conventional blood pressure control alone in patients with type 2 diabetes, hypertension, and renal disease in Switzerland.
MedLine Citation:
PMID:  16779715     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this health economic modelling study was to investigate the effect of irbesartan combined with conventional antihypertensive medications compared to conventional antihypertensive therapy alone on the progression of nephropathy in patients with hypertension, type 2 diabetes and microalbuminuria in a Swiss setting.
METHODS: In simulated patients with hypertension and type 2 diabetes, treatment of microalbuminuria with irbesartan 300 mg daily plus conventional antihypertensive medications was compared to a control regimen (conventional medications excluding angiotensin converting enzyme inhibitors, other angiotensin-2-receptor antagonist and dihydropyridine calcium channel blockers). Progression from microalbuminuria to nephropathy, doubling of serum creatinine, ESRD, and all-cause mortality was simulated over a 25-year time horizon using a published Markov model adapted to a Swiss setting. Transition probabilities were based on the Irbesartan in Reduction of Microalbuminuria-2 Study, Irbesartan in Diabetic Nephropathy Trial and other sources. Costs and clinical outcomes were discounted at 5% annually according to Swiss guidelines, and a third party payer perspective was taken.
RESULTS: Treatment with irbesartan was projected to improve mean life expectancy by 0.57 years compared to conventional antihypertension treatment (undiscounted 1.22 years). Irbesartan treatment was associated with cost savings of CHF 21,488 per patient over the 25-year time horizon. Sensitivity analysis showed that irbesartan therapy remained dominant to conventional antihypertension treatment over a range of plausible assumptions.
CONCLUSIONS: Addition of irbesartan to conventional antihypertension therapy was projected to improve life expectancy and reduce costs in hypertensive patients with type 2 diabetes and microalbuminuria in a Swiss setting.
Authors:
Andrew J Palmer; Stéphane Roze; William J Valentine; Joshua A Ray; Andreas Frei; Michel Burnier; Bernhard Hess; Giatgen A Spinas; Michael Brändle
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Swiss medical weekly     Volume:  136     ISSN:  1424-7860     ISO Abbreviation:  Swiss Med Wkly     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-06-16     Completed Date:  2006-10-27     Revised Date:  2011-02-15    
Medline Journal Info:
Nlm Unique ID:  100970884     Medline TA:  Swiss Med Wkly     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  346-52     Citation Subset:  IM    
Affiliation:
Center for Outcomes Research (CORE), Binningen/Basel, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Albuminuria / drug therapy*,  economics
Angiotensin II Type 1 Receptor Blockers / administration & dosage,  economics,  therapeutic use*
Antihypertensive Agents / administration & dosage,  economics,  therapeutic use*
Biphenyl Compounds / administration & dosage,  economics,  therapeutic use*
Cohort Studies
Cost Savings
Creatinine / blood
Diabetes Mellitus, Type 2 / drug therapy*,  economics
Diabetic Nephropathies / drug therapy*,  economics
Follow-Up Studies
Humans
Hypertension / complications,  drug therapy*,  economics
Life Expectancy
Markov Chains
Practice Guidelines as Topic
Switzerland
Tetrazoles / administration & dosage,  economics,  therapeutic use*
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Antihypertensive Agents; 0/Biphenyl Compounds; 0/Tetrazoles; 138402-11-6/irbesartan; 60-27-5/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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