Title
Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus: An ADVANCE trial-based analysis
Date of this Version
9-20-2010
Document Type
Journal Article
Abstract
Objective: To determine the cost-effectiveness of routine administration, irrespective of blood pressure (BP), of a fixed-dose combination of perindopril and indapamide to patients with type 2 diabetes mellitus.
Design, setting and participants: Prospective cost-effectiveness analysis within the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial, an international, multicentre, randomised controlled trial of 11 140 participants with type 2 diabetes randomly allocated to receive perindopril plus indapamide (4mg-1.25mg/day) or placebo.
Main outcome measures: Health-related quality-of-life measured by the EuroQol-5D, resource utilisation, and cost-effectiveness (cost per death averted at 4.3 years' average follow-up, and estimated cost per life-year gained, by extrapolation).
Results: The mean health-related quality-of-life score of survivors was 0.80 (on a 0-1 scale [death to full health]), with no difference between treatment groups. Active treatment reduced hospital admissions for coronary heart disease and coronary revascularisation by 5%. For the Australian participants, perindopril-indapamide cost A$1368 per patient during the trial period, but reduced total hospitalisation costs by A$410 and other medication costs (mainly other BP-lowering drugs) by A$332. The absolute reduction in all-cause mortality for the active treatment group was 1.1%, giving a cost per life saved of A$49 200. Lifetime extrapolation gave an estimated cost per life-year saved of A$10 040 (discounted at 5% per year).
Conclusion: The combination of perindopril and indapamide in patients with type 2 diabetes appears to be cost-effective.
Trial registration: United States National Library of Medicine NCT00145925.
This document has been peer reviewed.
Publication Details
Published Version.
Glasziou, P. P., Clarke, P., Alexander, J., Rajmokan, M., Beller, E., Woodward, M., Chalmers, J., Poulter, N., & Patel, A. (2010). Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus: An ADVANCE trial-based analysis. Medical Journal of Australia (MJA), 193(6), 320-324.
Access the Journal's homepage.
2010 HERDC submission. FoR Code: 111717, 110399
© Copyright Australasian Medical Publishing Company, 2010