THE COMPARATIVE COST-EFFICACY ANALYSIS OF VARIOUS ANTIHYPERTENSIVE THERAPIES
https://doi.org/10.20996/1819-6446-2009-5-5-35-40
Abstract
Aim. To perform the comparative cost-efficacy analysis of various antihypertensive therapies in hypertensives patients.
Material and methods. 140 hypertensive patients with history of ineffective antihypertensive therapy were randomized in to 4 groups, 35 patients in each one. Patients of Group A received indapamide retard plus perindopril; group B - indapamide retard plus amlodipine; group C - amlodipine plus lisinopril; group D - amlodipine plus bisoprolol. The Russian version of general questionnaire MOS-SF-36 was applied for quality of a life estimated. Endothelium function was evaluated with B-mode ultrasonography (Acuson 128 ХР/10). Albuminuria level was detected by immunoturbometric method (Integra-700, Roche).
Results. The drug combination B had the least cost. The drug combination C was the most effective. The drug combination C was the most economically rational. The drug combination A was the least economically rational for BP reduction. However the drug combination A was comparable with drug combination C in effects on quality of life and on endothelium function, and it was the most economically rational for albuminuria reduction.
Conclusion. Indapamide retard plus perindopril combination is the most economically rational in patients with target-organ lesions (nephropathy). Lisinopril plus amlodipine combination is economically rational in patients without target-organ lesions.
About the Authors
S. V. MalchikovaRussian Federation
K. Marxa ul. 112, Kirov, 610027
E. I. Tarlovskaya
Russian Federation
K. Marxa ul. 112, Kirov, 610027
References
1. Chen G.J., Ferrucci L., Moran W.P., Pahor M. A cost-minimization analysis of diuretic-based antihypertensive therapy reducing cardiovascular events in older adults with isolated systolic hypertension. Cost Eff Resour Alloc 2005;3(1):2.
2. Mancia G. Prevention and treatment of stroke in patients with hypertension. Clin Ther 2004; 26(5):631-48.
3. Hodgson T.A., Cai L. Medical care expenditures for hypertension, its complications, and its comorbidities. Med Care 2001;39(6):599–615.
4. Monane M., Glynn R.J., Gurwitz J.H., et al. Trends in medication choices for hypertension in the elderly. The decline of the thiazides. Hypertension 1995;25(5):1045-51.
5. Fischer M.A., Avorn J. Economic implications of evidence-based prescribing for hypertension: can better care cost less? JAMA 2004;291:1850-6.
6. Mancia G., De Backer G., Dominiczak A. et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25(6):1105- 87.
7. Рекомендации Российского медицинского общества по артериальной гипертонии и Всероссийского научного общества кардиологов. Кардиоваскулярная терапия и профилактика 2008; 7(6) приложение:2-32.
8. Ambrosioni E. Pharmacoeconomic challenges in disease management of hypertension. J Hypertens Suppl 2001;19(3):S33-40.
9. Фрисман М.В., Гельцер Б.И. Анализ прямых расходов при лечении некоторыми гипотензивными препаратами. Проблемы стандартизации в здравоохранении 1999;(4):109.
10. Захаревич О.А., Леонова М.В., Белоусов Ю.Б.. Анализ минимизации затрат и "затраты-эффективность" лечения больных мягкой и умеренной артериальной гипертонией. Проблемы стандартизации в здравоохранении 2001;(2):47-51.
11. Отраслевой стандарт "Клинико-экономические исследования. Общие положения" (ОСТ 91500.14.0001-2002).
12. Сelermajer D., Sorensen K., Gooch V., et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992;340(8828):1111-5.
Review
For citations:
Malchikova S.V., Tarlovskaya E.I. THE COMPARATIVE COST-EFFICACY ANALYSIS OF VARIOUS ANTIHYPERTENSIVE THERAPIES. Rational Pharmacotherapy in Cardiology. 2009;5(5):35-40. (In Russ.) https://doi.org/10.20996/1819-6446-2009-5-5-35-40