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An Economic Evaluation of a Perindopril-Based Blood Pressure Lowering Regimen for Patients Who Have Suffered a Cerebrovascular Event

Objectives Cerebrovascular disease (or stroke) is one of the main causes of long-term disability and the second leading cause of death worldwide. The economic impact of stroke is clearly seen, as it is the largest single cause of bed occupancy in hospitals in England and accounts for 6% of hospital... Full description

Journal Title: The European journal of health economics 2009-02-01, Vol.10 (1), p.111-119
Main Author: Tavakoli, Manouchehr
Other Authors: Pumford, Neil , Woodward, Mark , Doney, Alex , Chalmers, John , MacMahon, Stephen , MacWalter, Ronald
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: Berlin/Heidelberg: Springer
ID: ISSN: 1618-7598
Link: https://www.ncbi.nlm.nih.gov/pubmed/18446392
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title: An Economic Evaluation of a Perindopril-Based Blood Pressure Lowering Regimen for Patients Who Have Suffered a Cerebrovascular Event
format: Article
creator:
  • Tavakoli, Manouchehr
  • Pumford, Neil
  • Woodward, Mark
  • Doney, Alex
  • Chalmers, John
  • MacMahon, Stephen
  • MacWalter, Ronald
subjects:
  • Aged
  • Analysis
  • Angiotensin-Converting Enzyme Inhibitors - economics
  • Angiotensin-Converting Enzyme Inhibitors - therapeutic use
  • Blood pressure
  • Cardiovascular disease
  • Cerebrovascular disease
  • Cost analysis
  • Cost estimates
  • Cost-Benefit Analysis
  • Death
  • Disability
  • Economic impact
  • Economic Policy
  • Expenditures
  • Female
  • Health care costs
  • Health Care Management
  • Health Economics
  • Heart failure
  • Hospital Costs
  • Humans
  • Hypertension
  • Hypertension - complications
  • Hypertension - drug therapy
  • Hypertension - economics
  • Male
  • Markov Chains
  • Markov models
  • Medical care, Cost of
  • Medical colleges
  • Medicine
  • Medicine & Public Health
  • Middle Aged
  • Monte Carlo Method
  • Mortality
  • Original Paper
  • Patients
  • Perindopril - economics
  • Perindopril - therapeutic use
  • Pharmacoeconomics and Health Outcomes
  • Public Finance
  • Public Health
  • Quality-Adjusted Life Years
  • Stroke
  • Stroke - complications
  • Stroke - economics
  • Stroke - prevention & control
  • Strokes
  • Studies
  • Unit costs
ispartof: The European journal of health economics, 2009-02-01, Vol.10 (1), p.111-119
description: Objectives Cerebrovascular disease (or stroke) is one of the main causes of long-term disability and the second leading cause of death worldwide. The economic impact of stroke is clearly seen, as it is the largest single cause of bed occupancy in hospitals in England and accounts for 6% of hospital costs. This analysis is the first to quantify the economic consequences of a blood pressure lowering regimen based on the PROGRESS study (perindopril-based regimen), for reducing future cardiovascular events. Design A Markov decision analytical model was used to estimate the cost per quality adjusted life year (QALY) of blood pressure lowering in the treatment of patients presenting with a cerebrovascular event. The health states are based upon Barthel indices for which resource utilisation and health benefits have previously been estimated. Setting The participants for the economic analysis were obtained from the PROGRESS study database. 6,105 clinical study participants were recruited through both primary and secondary care centres. Participants The mean age was 64 years; 70% were male in the original study. Interventions In the PROGRESS study, blood pressure lowering by a perindopril-based regimen was compared to standard care. Main outcome measures Cost per quality adjusted life year for the duration of the study (4 years) and for a time span of 20 years. Results Using only direct hospital medical costs, the cost per QALY for a perindopril based regimen is £6,927 for the base study period and £10,133 for a 20-year time period. These results are sensitive to the cost of perindopril, the cost of the stroke unit, length of stay, and to a lesser extent, the cost of indapamide. Conclusions This analysis demonstrates a cost-effective treatment for patients suffering a cerebrovascular event with a blood pressure lowering regimen. The findings of this study are in line with current decisions and guidance by the national institute for health and clinical excellence (NICE) in England.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1618-7598
fulltext: fulltext
issn:
  • 1618-7598
  • 1618-7601
url: Link


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titleAn Economic Evaluation of a Perindopril-Based Blood Pressure Lowering Regimen for Patients Who Have Suffered a Cerebrovascular Event
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descriptionObjectives Cerebrovascular disease (or stroke) is one of the main causes of long-term disability and the second leading cause of death worldwide. The economic impact of stroke is clearly seen, as it is the largest single cause of bed occupancy in hospitals in England and accounts for 6% of hospital costs. This analysis is the first to quantify the economic consequences of a blood pressure lowering regimen based on the PROGRESS study (perindopril-based regimen), for reducing future cardiovascular events. Design A Markov decision analytical model was used to estimate the cost per quality adjusted life year (QALY) of blood pressure lowering in the treatment of patients presenting with a cerebrovascular event. The health states are based upon Barthel indices for which resource utilisation and health benefits have previously been estimated. Setting The participants for the economic analysis were obtained from the PROGRESS study database. 6,105 clinical study participants were recruited through both primary and secondary care centres. Participants The mean age was 64 years; 70% were male in the original study. Interventions In the PROGRESS study, blood pressure lowering by a perindopril-based regimen was compared to standard care. Main outcome measures Cost per quality adjusted life year for the duration of the study (4 years) and for a time span of 20 years. Results Using only direct hospital medical costs, the cost per QALY for a perindopril based regimen is £6,927 for the base study period and £10,133 for a 20-year time period. These results are sensitive to the cost of perindopril, the cost of the stroke unit, length of stay, and to a lesser extent, the cost of indapamide. Conclusions This analysis demonstrates a cost-effective treatment for patients suffering a cerebrovascular event with a blood pressure lowering regimen. The findings of this study are in line with current decisions and guidance by the national institute for health and clinical excellence (NICE) in England.
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subjectAged ; Analysis ; Angiotensin-Converting Enzyme Inhibitors - economics ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Blood pressure ; Cardiovascular disease ; Cerebrovascular disease ; Cost analysis ; Cost estimates ; Cost-Benefit Analysis ; Death ; Disability ; Economic impact ; Economic Policy ; Expenditures ; Female ; Health care costs ; Health Care Management ; Health Economics ; Heart failure ; Hospital Costs ; Humans ; Hypertension ; Hypertension - complications ; Hypertension - drug therapy ; Hypertension - economics ; Male ; Markov Chains ; Markov models ; Medical care, Cost of ; Medical colleges ; Medicine ; Medicine & Public Health ; Middle Aged ; Monte Carlo Method ; Mortality ; Original Paper ; Patients ; Perindopril - economics ; Perindopril - therapeutic use ; Pharmacoeconomics and Health Outcomes ; Public Finance ; Public Health ; Quality-Adjusted Life Years ; Stroke ; Stroke - complications ; Stroke - economics ; Stroke - prevention & control ; Strokes ; Studies ; Unit costs
ispartofThe European journal of health economics, 2009-02-01, Vol.10 (1), p.111-119
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descriptionObjectives Cerebrovascular disease (or stroke) is one of the main causes of long-term disability and the second leading cause of death worldwide. The economic impact of stroke is clearly seen, as it is the largest single cause of bed occupancy in hospitals in England and accounts for 6% of hospital costs. This analysis is the first to quantify the economic consequences of a blood pressure lowering regimen based on the PROGRESS study (perindopril-based regimen), for reducing future cardiovascular events. Design A Markov decision analytical model was used to estimate the cost per quality adjusted life year (QALY) of blood pressure lowering in the treatment of patients presenting with a cerebrovascular event. The health states are based upon Barthel indices for which resource utilisation and health benefits have previously been estimated. Setting The participants for the economic analysis were obtained from the PROGRESS study database. 6,105 clinical study participants were recruited through both primary and secondary care centres. Participants The mean age was 64 years; 70% were male in the original study. Interventions In the PROGRESS study, blood pressure lowering by a perindopril-based regimen was compared to standard care. Main outcome measures Cost per quality adjusted life year for the duration of the study (4 years) and for a time span of 20 years. Results Using only direct hospital medical costs, the cost per QALY for a perindopril based regimen is £6,927 for the base study period and £10,133 for a 20-year time period. These results are sensitive to the cost of perindopril, the cost of the stroke unit, length of stay, and to a lesser extent, the cost of indapamide. Conclusions This analysis demonstrates a cost-effective treatment for patients suffering a cerebrovascular event with a blood pressure lowering regimen. The findings of this study are in line with current decisions and guidance by the national institute for health and clinical excellence (NICE) in England.
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14Expenditures
15Female
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17Health Care Management
18Health Economics
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22Hypertension
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24Hypertension - drug therapy
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30Medical colleges
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abstractObjectives Cerebrovascular disease (or stroke) is one of the main causes of long-term disability and the second leading cause of death worldwide. The economic impact of stroke is clearly seen, as it is the largest single cause of bed occupancy in hospitals in England and accounts for 6% of hospital costs. This analysis is the first to quantify the economic consequences of a blood pressure lowering regimen based on the PROGRESS study (perindopril-based regimen), for reducing future cardiovascular events. Design A Markov decision analytical model was used to estimate the cost per quality adjusted life year (QALY) of blood pressure lowering in the treatment of patients presenting with a cerebrovascular event. The health states are based upon Barthel indices for which resource utilisation and health benefits have previously been estimated. Setting The participants for the economic analysis were obtained from the PROGRESS study database. 6,105 clinical study participants were recruited through both primary and secondary care centres. Participants The mean age was 64 years; 70% were male in the original study. Interventions In the PROGRESS study, blood pressure lowering by a perindopril-based regimen was compared to standard care. Main outcome measures Cost per quality adjusted life year for the duration of the study (4 years) and for a time span of 20 years. Results Using only direct hospital medical costs, the cost per QALY for a perindopril based regimen is £6,927 for the base study period and £10,133 for a 20-year time period. These results are sensitive to the cost of perindopril, the cost of the stroke unit, length of stay, and to a lesser extent, the cost of indapamide. Conclusions This analysis demonstrates a cost-effective treatment for patients suffering a cerebrovascular event with a blood pressure lowering regimen. The findings of this study are in line with current decisions and guidance by the national institute for health and clinical excellence (NICE) in England.
copBerlin/Heidelberg
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pmid18446392
doi10.1007/s10198-008-0108-3