The Cost-Effectiveness Analysis of Irbesartan in the Treatment of Hypertensive Type 2 Diabetic Patients with Microalbuminuria in China
- VernacularTitle:厄贝沙坦治疗中国高血压性2型糖尿病伴有微蛋白尿症患者的成本-效果分析
- Author:
Shanlian HU
;
Wen CHEN
- Publication Type:Journal Article
- Keywords:
Hypertension;
Type2diabetes;
Microalbuminuria;
Irbesartan;
Markov model
- From:
China Pharmacy
1991;0(03):-
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To evaluate the cumulative incidence of end-stage renal disease(ESRD)in Chinese hypertensive type2diabetic patients with microalbuminuria(DHM)treated with different regimes,and to provide reference for decision makers.METHODS:A peer-reviewed Markov model that simulated progression from microalbuminuria to nephropathy,dou?bling of serum creatinine,ESRD,and all-cause mortality in patients with DHM was adapted to China.Three strategies were compared:(1)early use of irbesartan(i.e.prompt treatment in subjects with microalbuminuria);(2)late use of irebesartan(i.e.as from overt nephropathy);(3)standard hypertension care(with comparable blood pressure control).Cumulative incidence of ESRD,costs and life expectancy were projected for a hypothetical cohort of1000subjects.Treatment-specific progression and mortality probabilities were derived from published trials:IRMA-2(in microalbuminuria)and IDNT(in overt nephropathy).Medical management and cost data per state were obtained from published local sources.A flexible time horizon up to25years and third party payer perspective were used.Future costs and LE were discounted at3%yearly.RESULTS:When compared with standard blood pressure control,early use of irbesartan was evaluated to reduce the cumulative incidence of ESRD from(mean?standard deviation)8%to22%,save RMB30348(US＄3667),and add0.638life years per treated patient.Late use of irbesartan was dominant over control group but dominated by early irbesartan.Break-even occurred after13years.CON?CLUSION:Treating DHM patients by early use of irbesartan is evaluated to reduce the incidence of ESRD,extend life and reduce costs.Treating patients at a later stage is still beneficial,however to a lower extent.
