Abstract
Compare cost-effectiveness of use of 8 drugs of antihypertensive group ACEI (fosinopril, lisinopril, ramipril and perindopril) and ARBS II (losartan, valsartan, candesartan and telmisartan) in patients with arterial hypertension in Russia for one-year period. The criterion of effectiveness in the pharmacoeconomic study is the achievement of target blood pressure levels. Apart from efficiency criterion determination for cost-effectiveness analysis as well as cost analysis unwanted cardiovascular event are identified including myocardial infarction, stroke and heart failure, as well as side effects of drug therapy such as hypotension, cough and angioedema. Efficacy data and the incidence of cardiovascular events and side effects of the investigated drugs are taken from randomized clinical studies. Direct costs analysis is carried out based on existing standards for the provision of emergency and specialized medical care in arterial hypertension, myocardial infarction, stroke, heart failure and angioneurotic edema, as well as costs of relief of hypotension and cough and one of pharmacotherapy. For reference, we used the Euro: 1 Euro = 67 RUB. The effectiveness analysis shows that the highest blood pressure levels among the investigated drugs,is of ramipril – 85% and valsartan – 82,7% and the lowest perindopril – 46% and telmisartan – 58%.The highest total costs per year per patient are for ramipril - 1038 and losartan - 1022 €, the lowest total cost had fosinopril – 340 € and lisinopril – 415 €. In the result cost-effectiveness analysis, the highest cost-effectiveness ratio is for losartan – 15 € and telmisartan – 12 €, and the lowest ratio have the fosinopril – 4 and lisinopril – 7 €. The treatment regimen with the use of the medicinal product fosinopril is dominant from the point of view of cost-effectiveness analysis because this therapy is less costly for a single case of achievement of target blood pressure levels.
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