Preview

Rational Pharmacotherapy in Cardiology

Advanced search

PRELIMINARY RESULTS OF COMPARATIVE PHARMACOECONOMIC PROSPECTIVE STUDY OF DIFFERENT THERAPIES OF ARTERIAL HYPERTENSION

https://doi.org/10.20996/1819-6446-2012-8-2-47-52

Abstract

Aim. To carry out a comparative pharmacoeconomic analysis of two different types of antihypertensive therapy in patients with arterial hypertension (HT). Material and methods. 38 patients with essential HT (aged 18 to 70 years, 11 males and 27 females) associated with metabolic syndrome, and having a history of previous ineffective antihypertensive therapy were included into the study. The patients were randomized into 2 groups. Patients of V/A group received a fixed combination of valsartan and amlodipine (Exforge, Novartis) in dose of 5/160 and 10/160 mg depending on blood pressure (BP) level. Patients of L/A group received losartan (Lorista, KRKA) in dose of 100 mg and amlodipine (Tenox, KRKA) in dose of 5 and 10 mg. Treatment duration was 24 weeks. If target level of BP was not achieved during 12 weeks, indapamide retard was added to the therapies (Ravel SR, KRKA). Dinamics of BP and left ventricular mass index (LVMI) were considered. Cost-effectiveness method of analysis was used. Results. In V/A group 75% of patients achieved target BP levels for 24 weeks, while in L/A group — 33.3% of patients, and 16.7% of patients more after indapamide addition. L/A therapy cost was lower in comparison with this of V/A therapy: 57864.24 vs 156671.0 rubles per 24 weeks, respectively. Calculation shows that additional cost of 669.23 rubles during 24 weeks is needed to achieve BP target level in every next patient when V/A therapy is used instead of L/A therapy. LVMI reduction by 1% took 1015.13 rubles cost in V/A group and almost 6 times more in L/A group. Conclusion. Pharmacoeconomic analysis revealed that generic combination of L/A is the most cost-effective for BP reduction. Very low cost is required to achieve additional effect with original fixed V/A combination. V/A combination is the most economical for the left ventricular hypertrophy reduction. Thus, V/A combination is rational for use in HT patients with severe target-organs damage.

About the Authors

E. I. Tarlovskaya
Kirov State Medical Academy
Russian Federation


N. S. Maksimchuk
Kirov State Medical Academy
Russian Federation


S. V. Malchikova
Kirov State Medical Academy
Russian Federation


M. V. Avksentieva
The Russian National Research Medical University named after N.I. Pirogov
Russian Federation


References

1. Gilyarevskiy S.R. The clinical effectiveness and economic feasibility of the use of combined drugs with fixed doses of ACE inhibitor and a thiazide diuretic. Farmateka 2005;10: 27–35. Russian (Гиляревский С.Р . Клиническая эффективность и экономическая целесообразность применения комбинированных препаратов с фиксированными дозами ингибитора ангиотензинпревращающего фермента и тиазидного диуретика. Фарматека 2005;10: 27–35).

2. Leonova M.V., Belousov D.Yu., Shteynberg L.L. et al. The first results of the pharmacoepidemiological studies of hypertension (PIFAGOR III). Kachestvennaya Klinicheskaya Praktika 2010; (1): 54–60. Russian (Леонова М.В., Белоусов Д.Ю., Штейнберг Л.Л. и др. Первые результаты фармакоэпидемиологического исследования артериальной гипертонии ПИФАГОР III. Качественная Клиническая Практика 2010; (1): 54–60).

3. Leonova MV, Erofeeva SB, Bykov AV, Belousov IuB. Pharmacoeconomic analysis of antihypertensive therapy: advantages of fixed combinations. Kardiologiia 2008;48(1):43–50. Russian (Леонова М.В., Ерофеева С.Б., Быков А.В., Белоусов Ю.Б. Фармакоэкономический анализ антигипертензивной терапии: преимущества фиксированных комбинаций. Кардиология 2008; (1): 43–50).

4. Ostroumova O.D., Nedogoda S.V., Mamaev V.I., Shorikova E.G. Pharmacoeconomic aspects of the effectiveness of ACE inhibitors in the hypertension and heart failure. Russkiy Meditsinskiy Zhurnal 2003; 11(5): 262–266. Russian (Остроумова О.Д., Недогода С.В., Мамаев В.И., Шорикова Е.Г . Фармакоэкономические аспекты эффективности ингибиторов ангиотензипревращающего фермента при артериальной гипертонии и сердечной недостаточности. Русский Медицинский Журнал 2003; 11(5): 262–266).

5. Fischer M.A., Avorn J. Economic implications of evidence-based prescribing for hypertension: can better care cost less? JAMA 2004; 291(15):1850–6.

6. Chazova I.E., Karpov Yu.A., Vigdorchik A.V. The efficacy and safety of the combination of amlodipine and valsartan in the treatment of hypertension in clinical practice: first results of the Russian observational study EKSTRA. Sistemnye Gipertenzii 2010; (2): 18–26. Russin (Чазова И.Е., Карпов Ю.А., Вигдорчик А.В. Эффективность и безопасность комбинации амлодипина и валсартана в лечении артериальной гипертонии в условиях реальной клинической практики: первые результаты российского наблюдательного исследования ЭКСТРА. Системные Гипертензии 2010; (2): 18–26).

7. Karpov Yu.A., Chazova I.E., Vigdorchik A.V. Efficacy and safety of fixed combination of amlodipine and valsartan in the treatment of hypertension in clinical practice: results of the Russian observational study EKSTRA-2. Sistemnye Gipertenzii 2010; (4): 14–21. Russian (Карпов Ю.А., Чазова И.Е., Вигдорчик А.В. Эффективность и безопасность фиксированной комбинации амлодипина и валсартана в лечении артериальной гипертонии в условиях реальной клинической практики: результаты Российского наблюдательного исследования ЭКСТРА-2. Системные Г ипертензии 2010; (4): 14–21).

8. Nixon RM, Muller E, Lowy A et al. Valsartan vs. other angiotensin II receptor blockers in the treatment of hypertension: a meta-analytical approach. Int J Clin Pract 2009; 63 (5): 766–75.


Review

For citations:


Tarlovskaya E.I., Maksimchuk N.S., Malchikova S.V., Avksentieva M.V. PRELIMINARY RESULTS OF COMPARATIVE PHARMACOECONOMIC PROSPECTIVE STUDY OF DIFFERENT THERAPIES OF ARTERIAL HYPERTENSION. Rational Pharmacotherapy in Cardiology. 2012;8(2):173-178. (In Russ.) https://doi.org/10.20996/1819-6446-2012-8-2-47-52

Views: 644


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1819-6446 (Print)
ISSN 2225-3653 (Online)