OBJECTIVE: Cost-effectiveness analysis of combined enalapril-nitrendipine therapy (E/N), as second-line therapy for light or moderate hypertension. DESIGN: Theoretical model of cost-effectiveness, based on the norms of hypertension treatment in primary care, the considered view of a panel of experts and the direct costs of health resources and purchase of medication. SETTING: Spanish National Health system. PARTICIPANTS: Simulation of 1000 patients with hypertension, with a time horizon of one year. INTERVENTIONS: After a prior failure of the first-line treatment with either enalapril or nitrendipine, an evaluation was made of the possibilities of increasing dosage of the first-line treatment, changing the drug or administering the E/N combination. MAIN MEASUREMENT: The likelihoods, in the primary care context, of controlling diastolic pressure, of abandonment and of using the two strategies or not were measured, as were the use of health resources in each situation, and costs of resource use and of medication. RESULTS: The cost-effectiveness quotient of the combined E/N treatment was consistently more efficient than the increase in dose or change to another drug. This was so, whether the treatment was started with enalapril (301.06 euros vs 337.97 euros and 588.42 euros) or with nitrendipine (331.5 euros vs 469.88 euros and 579.76 euros). CONCLUSIONS: Combined therapy (E/N) is, on the basis of the assumptions made in the model, an efficient therapy option. Therefore, it can be recommended for prescription.
OBJECTIVE: Cost-effectiveness analysis of combined enalapril-nitrendipine therapy (E/N), as second-line therapy for light or moderate hypertension. DESIGN: Theoretical model of cost-effectiveness, based on the norms of hypertension treatment in primary care, the considered view of a panel of experts and the direct costs of health resources and purchase of medication. SETTING: Spanish National Health system. PARTICIPANTS: Simulation of 1000 patients with hypertension, with a time horizon of one year. INTERVENTIONS: After a prior failure of the first-line treatment with either enalapril or nitrendipine, an evaluation was made of the possibilities of increasing dosage of the first-line treatment, changing the drug or administering the E/N combination. MAIN MEASUREMENT: The likelihoods, in the primary care context, of controlling diastolic pressure, of abandonment and of using the two strategies or not were measured, as were the use of health resources in each situation, and costs of resource use and of medication. RESULTS: The cost-effectiveness quotient of the combined E/N treatment was consistently more efficient than the increase in dose or change to another drug. This was so, whether the treatment was started with enalapril (301.06 euros vs 337.97 euros and 588.42 euros) or with nitrendipine (331.5 euros vs 469.88 euros and 579.76 euros). CONCLUSIONS: Combined therapy (E/N) is, on the basis of the assumptions made in the model, an efficient therapy option. Therefore, it can be recommended for prescription.
Authors: J A Staessen; R Fagard; L Thijs; H Celis; G G Arabidze; W H Birkenhäger; C J Bulpitt; P W de Leeuw; C T Dollery; A E Fletcher; F Forette; G Leonetti; C Nachev; E T O'Brien; J Rosenfeld; J L Rodicio; J Tuomilehto; A Zanchetti Journal: Lancet Date: 1997-09-13 Impact factor: 79.321
Authors: J A Staessen; L Thijs; R H Fagard; W H Birkenhäger; G Arabidze; S Babeanu; B Gil-Extremera; C J Bulpitt; C Davidson; P W de Leeuw; A D Efstratopoulos; A E Fletcher; R Fogari; M Jääskivi; K Kawecka-Jaszcz; C Nachev; J C Petrie; M L Seux; J Tuomilehto; J Webster; Y Yodfat Journal: Hypertension Date: 1998-09 Impact factor: 10.190
Authors: M Belén Ferro-Rey; Alex Roca-Cusachs; Antoni Sicras-Mainar; Carlos Alvarez-Martín; Marina de Salas-Cansado Journal: Aten Primaria Date: 2011-01-08 Impact factor: 1.137