Abstract
BackgroundHypertension is one of the leading causes of cardiovascular disease (CVD). A range of antihypertensive drugs exists, and their prices vary widely mainly due to patent rights. The objective of this study was to explore the cost-effectiveness of different generic antihypertensive drugs as first, second and third choice for primary prevention of cardiovascular disease.MethodsWe used the Norwegian Cardiovascular Disease model (NorCaD) to simulate the cardiovascular life of patients from hypertension without symptoms until they were all dead or 100 years old. The risk of CVD events and costs were based on recent Norwegian sources.ResultsIn single-drug treatment, all antihypertensives are cost-effective compared to no drug treatment. In the base-case analysis, the first, second and third choice of antihypertensive were calcium channel blocker, thiazide and angiotensin-converting enzyme inhibitor. However the sensitivity and scenario analyses indicated considerable uncertainty in that angiotensin receptor blockers as well as, angiotensin-converting enzyme inhibitors, beta blockers and thiazides could be the most cost-effective antihypertensive drugs.ConclusionsGeneric antihypertensives are cost-effective in a wide range of risk groups. There is considerable uncertainty, however, regarding which drug is the most cost-effective.
Highlights
Hypertension is one of the leading causes of cardiovascular disease (CVD)
This is the case for thiazides, beta blockers, calcium channel blockers (CCB), angiotensin receptor blockers (ARB) and angiotensin-converting-enzyme inhibitors (ACE) [2]
Disease-free individuals are subject to various primary CVD events: Acute myocardial infarction (AMI), stroke, heart failure, angina, death from cardiovascular disease
Summary
Hypertension is one of the leading causes of cardiovascular disease (CVD). The objective of this study was to explore the cost-effectiveness of different generic antihypertensive drugs as first, second and third choice for primary prevention of cardiovascular disease. Hypertension is a major risk factor for cardiovascular disease (CVD) such as acute myocardial infarction (AMI), stroke, heart failure and death. An array of randomized controlled trials (RCTs) has demonstrated that antihypertensive drugs can reduce the risk of CVD. This is the case for thiazides, beta blockers, calcium channel blockers (CCB), angiotensin receptor blockers (ARB) and angiotensin-converting-enzyme inhibitors (ACE) [2]. The controversy is partly related to the price of the different drugs, and partly to
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