Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus: an ADVANCE trial-based analysis

被引:11
作者
Glasziou, Paul P. [1 ]
Clarke, Philip [2 ]
Alexander, Jan [3 ]
Rajmokan, Mohana [4 ]
Beller, Elaine [3 ]
Woodward, Mark
Chalmers, John
Poulter, Neil [6 ]
Patel, Anushka [5 ]
机构
[1] Bond Univ, Gold Coast, Qld, Australia
[2] Univ Sydney, Dept Publ Hlth, Sydney, NSW 2006, Australia
[3] Univ Queensland, Queensland Clin Trials Ctr, Brisbane, Qld, Australia
[4] Queensland Hlth, Ctr Healthcare Related Infect Surveillance & Prev, Brisbane, Qld, Australia
[5] George Inst Int Hlth, Div Cardiovasc, Sydney, NSW, Australia
[6] Univ London Imperial Coll Sci Technol & Med, London, England
基金
英国医学研究理事会;
关键词
HYPERTENSION; PREVALENCE; HEALTH; AWARENESS; DISEASE; EVENTS; ADULTS; STATES; RISK;
D O I
10.5694/j.1326-5377.2010.tb03941.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 080 (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$49200 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
引用
收藏
页码:320 / 324
页数:5
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