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Cost-effectiveness study of nitrate therapy using a decision analysis methodology.

¹College of Pharmacy, University of Rhode Island, Kingston 02881.

Hospital Formulary

|April 1, 1994

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Isosorbide mononitrate (ISMO) offers a cost-effective treatment for stable angina compared to isosorbide dinitrate (ISDN) and nitroglycerin patches. ISMO demonstrates lower overall costs and improved patient management due to less titration and fewer side effects.

Area of Science:

Pharmacoeconomics
Clinical Practice Research
Health Services Research

Background:

Angina treatment involves various nitrate therapies with differing economic profiles.
Decision analysis provides a framework for evaluating treatment costs and clinical utility.
Understanding the economic impact is crucial for healthcare decision-makers.

Purpose of the Study:

To assess the economic impact of isosorbide mononitrate (ISMO) versus isosorbide dinitrate (ISDN) and nitroglycerin patches for stable angina.
To demonstrate the utility of decision analysis in healthcare economic evaluations.
To inform physicians, administrators, and manufacturers about cost-effective angina management.

Main Methods:

Decision analysis cost-assessment technology was employed.

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Comparative economic evaluation of ISMO, ISDN, and nitroglycerin patches.

Analysis focused on anticipated treatment costs in stable angina patients.

Main Results:

Isosorbide mononitrate (ISMO) showed lower total anticipated treatment costs than ISDN (28% reduction) and nitroglycerin patches (16% reduction).
Despite a higher unit cost, ISMO's overall economic advantage was demonstrated.
ISMO requires less dosing titration and is associated with fewer tolerance effects compared to ISDN and nitroglycerin patches.

Conclusions:

Isosorbide mononitrate (ISMO) presents a more cost-effective therapeutic option for stable angina management.
Decision analysis is a valuable tool for evaluating the economic implications of new pharmaceutical therapies.
Healthcare stakeholders should consider both clinical efficacy and economic factors in treatment choices.