BACKGROUND: In a multinational clinical trial, valsartan was statistically not inferior to captopril in reducing mortality and cardiovascular morbidity after myocardial infarction (MI) in patients with signs of heart failure and/or left ventricular dysfunction. We conducted a prospective economic evaluation to compare within-trial resource use, costs, and quality of life in patients receivingvalsartan, captopril, or both after MI. METHODS: We assigned country-specific unit costs to resource use data for 14703 patients and measured health-related quality of life in a subset of 4524 patients. We used the nonparametric bootstrap method to compare rates of resource use and costs, and a piecewise linear mixed-effects regression analysis to compare longitudinal measures of quality of life. RESULTS: There were no significant differences in rates of resource use between the valsartan and captopril groups. During an average follow-up of 2 years, total costs for patients receivingvalsartan were significantly higher than for patients receivingcaptopril (USD 14103 vs USD 13038; 95% CI USD 369-USD 1875). The cost differential was caused primarily by the cost of the study medications (USD 1056 for valsartan vs USD 165 for captopril; 95% CI USD 867 to USD 912). Quality of life did not differ significantly between groups. CONCLUSIONS: For most patients at high risk after MI, the availability of generic captopril confers a cost advantage over valsartan because of lower medication costs. The difference will be smaller or nonexistent in settings where brand-name ACE inhibitors are prescribed.
RCT Entities:
BACKGROUND: In a multinational clinical trial, valsartan was statistically not inferior to captopril in reducing mortality and cardiovascular morbidity after myocardial infarction (MI) in patients with signs of heart failure and/or left ventricular dysfunction. We conducted a prospective economic evaluation to compare within-trial resource use, costs, and quality of life in patients receiving valsartan, captopril, or both after MI. METHODS: We assigned country-specific unit costs to resource use data for 14703 patients and measured health-related quality of life in a subset of 4524 patients. We used the nonparametric bootstrap method to compare rates of resource use and costs, and a piecewise linear mixed-effects regression analysis to compare longitudinal measures of quality of life. RESULTS: There were no significant differences in rates of resource use between the valsartan and captopril groups. During an average follow-up of 2 years, total costs for patients receiving valsartan were significantly higher than for patients receiving captopril (USD 14103 vs USD 13038; 95% CI USD 369-USD 1875). The cost differential was caused primarily by the cost of the study medications (USD 1056 for valsartan vs USD 165 for captopril; 95% CI USD 867 to USD 912). Quality of life did not differ significantly between groups. CONCLUSIONS: For most patients at high risk after MI, the availability of generic captopril confers a cost advantage over valsartan because of lower medication costs. The difference will be smaller or nonexistent in settings where brand-name ACE inhibitors are prescribed.
Authors: Eldrin F Lewis; Marc A Pfeffer; Amy Feng; Hajime Uno; John J V McMurray; Robert Toto; Shravanthi R Gandra; Scott D Solomon; Moustafa Moustafa; Iain C Macdougall; Francesco Locatelli; Patrick S Parfrey Journal: Clin J Am Soc Nephrol Date: 2011-01-06 Impact factor: 8.237
Authors: Andrea Kuenzli; Heiner C Bucher; Inder Anand; Gregory Arutiunov; Leo C Kum; Robert McKelvie; Rizwan Afzal; Michel White; Alain J Nordmann Journal: PLoS One Date: 2010-04-01 Impact factor: 3.240
Authors: Meaghan Lunney; Marinella Ruospo; Patrizia Natale; Robert R Quinn; Paul E Ronksley; Ioannis Konstantinidis; Suetonia C Palmer; Marcello Tonelli; Giovanni Fm Strippoli; Pietro Ravani Journal: Cochrane Database Syst Rev Date: 2020-02-27
Authors: Simone A Huygens; Isaac Corro Ramos; Carlijn V C Bouten; Jolanda Kluin; Shih Ting Chiu; Gary L Grunkemeier; Johanna J M Takkenberg; Maureen P M H Rutten-van Mölken Journal: Eur J Health Econ Date: 2020-01-25
Authors: Simon Walker; Miqdad Asaria; Andrea Manca; Stephen Palmer; Chris P Gale; Anoop Dinesh Shah; Keith R Abrams; Michael Crowther; Adam Timmis; Harry Hemingway; Mark Sculpher Journal: Eur Heart J Qual Care Clin Outcomes Date: 2016-01-20