Economics of Nephroprotection in Arterial Hypertension and Type 2 Diabetes Mellitus

Based on results of large-scale controlled trials of irbesartan (1), valsartan (V) and amlodipine (A) (PRIME and MARVAL) we carried out the Markov's modeling of their pharmacoeconomic parameters in arterial hypertension (AH) combined with diabetes mellitus type 2 (DM 2) and microalbuminuria (MAU) projected for 8-years perspective. Cost and efficacy was evaluated taking into account years of life gained and outcomes of concomitant diseases and complications. Indexes of cost/efficacy (C/E) were calculated for each drug. Among investigated drugs I appeared to be the most economic at the account of retardation of development of terminal nephropathy and cardiovascular diseases. The use of I compared with V could save 565300 rub/100 patients/year. C/E of I was 26.5 and 37.4% lower that those of V and A, respectively. Costs of year of life saved was 12716,16432, and 18325 for 1, V, and A, respectively. Comparative pharmacoeconomic modeling of 8-year economic perspectives of 1, V and A demonstrated financial benefits of 1.