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Bayesian cost-effectiveness analysis based on the persistence with antihypertensive treatment.
Gianluca Baio1, Luca Degli Esposti, Ezio Degli Esposti
1University of Florence, Department of Statistics G Parenti, Viale Morgagni 53, 50134, Florence, Italy. baio@ds.unifi.it
Expert Review of Pharmacoeconomics & Outcomes Research
|October 8, 2009
Summary
This study compared five antihypertensive drugs, finding losartan offered effective treatment and cost-effectiveness. Atenolol was the least expensive initial therapy over one year.
Area of Science:
- Pharmacoeconomics
- Cardiovascular Medicine
- Public Health
Background:
- Antihypertensive medication choice impacts treatment persistence and healthcare costs.
- Understanding initial therapy effectiveness and cost is crucial for managing hypertension.
- Large-scale observational studies are valuable for real-world evidence in hypertension management.
Purpose of the Study:
- To compare the cost-effectiveness and treatment persistence of five initial antihypertensive agents.
- To analyze the economic impact of different antihypertensive drug classes in a large patient population.
- To identify which initial antihypertensive therapy is most likely to lead to effective and sustained treatment.
Main Methods:
- Observational study design utilizing a 1-year follow-up period.
- Inclusion of a large population cohort (approx. 360,000 residents) from the Ravenna Local Health Unit.
- Analysis of prescription data for five major antihypertensive agents among 4614 enrolled patients.
Main Results:
- Annual treatment costs varied significantly, from €44.27 for atenolol to €175.65 for losartan.
- Patients initiating losartan demonstrated a higher probability of effective antihypertensive treatment.
- Losartan treatment was associated with an average probability of 0.70 for cost-effective outcomes.
Conclusions:
- Initial antihypertensive therapy selection influences both treatment effectiveness and cost.
- Losartan emerges as a potentially superior choice for effective and cost-effective hypertension management.
- Further research into long-term outcomes and patient adherence is warranted.
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