Cost-utility analysis of eprosartan compared to enalapril in primary prevention and nitrendipine in secondary prevention in Europe &- the HEALTH model

  1. Schwander, B. 1
  2. Gradl, B. 4
  3. Zöllner, Y. 4
  4. Lindgren, P. 3
  5. Diener, H.-C. 2
  6. Lüders, S. 5
  7. Schrader, J. 5
  8. Villar, F.A. 8
  9. Greiner, W. 7
  10. Jönsson, B. 6
  1. 1 Analytica International, Lörrach, Germany
  2. 2 University of Duisburg-Essen
    info

    University of Duisburg-Essen

    Essen, Alemania

    ROR https://ror.org/04mz5ra38

  3. 3 I3innovus, Stockholm, Sweden
  4. 4 Solvay Pharmaceuticals Marketing and Licensing AG, Hegenheimermattweg 127, CH-4123 Allschwil, Switzerland
  5. 5 St.-Josefs-Hospital, Cloppenburg, Germany
  6. 6 Stockholm School of Economics
    info

    Stockholm School of Economics

    Estocolmo, Suecia

    ROR https://ror.org/01s5jzh92

  7. 7 Bielefeld University
    info

    Bielefeld University

    Bielefeld, Alemania

    ROR https://ror.org/02hpadn98

  8. 8 Universidad de La Rioja
    info

    Universidad de La Rioja

    Logroño, España

    ROR https://ror.org/0553yr311

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Revista:
Value in Health

ISSN: 1098-3015

Año de publicación: 2009

Volumen: 12

Número: 6

Páginas: 857-871

Tipo: Artículo

DOI: 10.1111/J.1524-4733.2009.00507.X PMID: 19508663 SCOPUS: 2-s2.0-67651238846 WoS: WOS:000268304600002 GOOGLE SCHOLAR

Otras publicaciones en: Value in Health

Repositorio institucional: lock_openAcceso abierto Editor

Resumen

Objective: To investigate the cost-utility of eprosartan versus enalapril (primary prevention) and versus nitrendipine (secondary prevention) on the basis of head-to-head evidence from randomized controlled trials. Methods: The HEALTH model (Health Economic Assessment of Life with Teveten® for Hypertension) is an object-oriented probabilistic Monte Carlo simulation model. It combines a Framingham-based risk calculation with a systolic blood pressure approach to estimate the relative risk reduction of cardiovascular and cerebrovascular events based on recent meta-analyses. In secondary prevention, an additional risk reduction is modeled for eprosartan according to the results of the MOSES study ("Morbidity and Mortality after Stroke - Eprosartan Compared to Nitrendipine for Secondary Prevention"). Costs and utilities were derived from published estimates considering European country-specific health-care payer perspectives. Results: Comparing eprosartan to enalapril in a primary prevention setting the mean costs per quality adjusted life year (QALY) gained were highest in Germany (24,036) followed by Belgium (17,863), the UK (16,364), Norway ( 13,834), Sweden ( 11,691) and Spain ( 7918). In a secondary prevention setting (eprosartan vs. nitrendipine) the highest costs per QALY gained have been observed in Germany (9136) followed by the UK (6008), Norway (1695), Sweden (907), Spain (-2054) and Belgium (-5767). Conclusions: Considering a 30,000 willingness-to-pay threshold per QALY gained, eprosartan is cost-effective as compared to enalapril in primary prevention (patients ≥50 years old and a systolic blood pressure ≥160 mm Hg) and cost-effective as compared to nitrendipine in secondary prevention (all investigated patients). © 2009, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).