Abstract
BackgroundWe evaluated the long-term cost-effectiveness of antihypertensive traditional Chinese medicines (TCMs) and to compare the cost-effectiveness of a combined treatment consisting of compound Apocynum tablets and Nifedipine sustained-release tablets with the cost-effectiveness of treatment with Nifedipine sustained-release tablets alone.MethodsA Markov model was used to simulate the potential incremental cost-effectiveness per quality-adjusted life year (QALY) to be gained from compound Apocynum tablets and Nifedipine sustained-release tablets compared with Nifedipine sustained-release tablets alone. Model parameter estimates were informed by previously published studies. The direct medical costs of outpatients with hypertension were estimated from the health care provider’s perspective. A 5% annual discount rate was applied to both costs and QALYs.ResultsTCMs combined with Nifedipine sustained-release tablets group generated a total 20-year cost of 11,517.94 RMB (US $1739.87), whereas Nifedipine sustained-release tablets alone group resulted in a 20-year cost of 7253.71 RMB (US $1095.73). TCMs combined with Nifedipine sustained-release tablets group resulted in a generation of 12.69 QALYs, whereas Nifedipine sustained-release tablets alone group resulted in 12.50. The incremental cost-utility ratio was 22,443.32 RMB (US $3390.23) per QALY. Considering the threshold of 1 GDP per capita in China in 2018 (US $9764.95), the combination of compound Apocynum tablets and Nifedipine sustained-release tablets was a cost-effective strategy. One-way and probabilistic sensitivity analysis showed unchanged results over an acceptable range.ConclusionsCombining Traditional Chinese Medicines with chemical medicines is more cost-effective strategy in the treatment of hypertension.
Highlights
We evaluated the long-term cost-effectiveness of antihypertensive traditional Chinese medicines (TCMs) and to compare the cost-effectiveness of a combined treatment consisting of compound Apocynum tablets and Nifedipine sustained-release tablets with the cost-effectiveness of treatment with Nifedipine sustained-release tablets alone
Model description and structure We developed a Markov model, using TreeAge Pro 2011 (TreeAge Software, Williamstown, MA, USA), from a Health care provider’s perspective to compare 20-year timeframe costs and health benefits associated with compound Apocynum tablets and Nifedipine sustained-release tablets for patients with hypertension
Base case analysis The Markov model was used for a cost-effectiveness analysis of the two treatments for hypertension (Table 3) in TreeAge Pro 2011
Summary
We evaluated the long-term cost-effectiveness of antihypertensive traditional Chinese medicines (TCMs) and to compare the cost-effectiveness of a combined treatment consisting of compound Apocynum tablets and Nifedipine sustained-release tablets with the cost-effectiveness of treatment with Nifedipine sustained-release tablets alone. Hypertension is one of the most common chronic diseases that threatens human health, and it is the major risk factor for cardiovascular diseases [1]. It has been reported [2] that 2 million people die of hypertension every year, 71% of the deaths caused by stroke are ACE inhibitors) [16, 17]. According to the Guidelines for the Rational Use of Hypertensive Drugs in China and the Chinese expert consensus document on antihypertensive therapy with single-pill combination [18, 19], it is indicated that two or more drugs should be used together. In 2015, the per capita medical expenses (outpatient and hospitalization expenses) of hypertension in China were $1123.88 per year, and the per capita medical expenses (including outpatient and hospitalization expenses) of patients with four primary hypertension complications were $1587.16 per year [4]
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