Volume 3, 2000
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Economic impact of Elantan LA compared to Isordil, Tenormin and Tildiem LA in
the treatment of stable angina in the UK
J Borghi, JF Guest
Pages 1-20 ¦ Abstract ¦
Secondary prevention with statin therapy: a budgetary-impact assessment for UK
primary care
C Phillips, R Smith, J Pittard
Pages 21-33 ¦ No abstract available
The clinical and financial impact of oral triptans in the management of migraine:
a systematic review
J Belsey
Pages 35-47 ¦ No abstract available
The cost-effectiveness of eformoterol via Turbohaler and salmeterol via pressurised
metered dose inhaler and metered dose powder inhaler in mild to moderate asthma
LM Campbell, F Berggren, C Emmas
Pages 49-60 ¦ No abstract available
Flora pro.activ: a clinical and financial impact analysis
C Phillips, J Belsey, J Schindler
Pages 61-76 ¦ No abstract available
Economic evaluation of rabeprazole, omeprazole and ranitidine in the treatment
of acid-related upper gastrointestinal disorders
T Wright
Pages 77-85 ¦ No abstract available
The cost-effectiveness in the UK of treating diabetic lower extremity ulcers
with becaplermin gel
O Ghatnekar, U Persson, M Willis, T Wright, K Ödegaard
Pages 87-95 ¦ No abstract available
Economic evaluation of ramipril in the treatment of patients at high risk for
cardiovascular events
ME Backhouse, A Richter, L Gaffney
Pages 97-109 ¦ Abstract ¦
Longitudinal glaucoma treatment patterns with brinzolamide versus dorzolamide
MT Halpern, S Sorensen, D Covert, J Hutton
Pages 111-120 ¦ No abstract available
Borghi J, Guest JF
Economic impact of Elantan LA compared to Isordil, Tenormin and Tildiem LA in
the treatment of stable angina in the UK
J Med Econ 2000; 3: 1-20
This study estimated the NHS cost of treating stable angina with Elantan LA compared
to Isordil, Tenormin and Tildiem LA. Angina-related healthcare resource use from
the UK Mediplus® database was obtained for new patients, switched patients and existing patients
who received one of the four drugs for stable angina and had one of the following
Read Codes: history of angina pectoris; history of angina in the last year; angina
control; and angina pectoris. Resource use was stratified according to the following
comorbidities: ischaemic heart disease (excluding angina); hypertension; congestive
cardiac failure; hypercholesterolaemia; and cerebrovascular disease. National
resource costs (at 1997/98 prices) were assigned to the resources used, to estimate
the cost of each treatment strategy over one year to achieve the same level of
clinical effectiveness.
The cost differences between treatments were largely attributable to differences
in hospitalisation rates, since primary care resource use was broadly similar
across treatments. The acquisition cost of the anti-anginals, hospitalisation
and GP visits were the main cost drivers. However, sensitivity analyses showed
the results to be robust to realistic changes in the incidence of hospitalisation
and the frequency of GP visits.
In conclusion, clinical decisions about choosing between Elantan LA, Isordil,
Tenormin and Tildiem LA, which all have similar effectiveness, should not be based
on their acquisition cost alone. By accounting for a broader range of healthcare
resource use, the nitrates were found to generate economic benefits in all patient
groups.
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Backhouse ME, Richter A, Gaffney L
Economic evaluation of ramipril in the treatment of patients at high risk for
cardiovascular events
J Med Econ 2000; 3: 97-109
Cardiovascular disease (CVD) is a primary cause of death and morbidity in the
United Kingdom (UK). Recently, the Heart Outcomes Prevention Evaluation (HOPE)
trial demonstrated significant survival and morbidity benefits associated with
ramipril use in the treatment of patients at high risk from cardiovascular events.
The purpose of this paper is to assess whether, and to what extent, these clinical
benfits might translate into economic benefits from the perspective of the UK
NHS. Using trial data and a decision-analytic model, our base case estimate of
cost-effectiveness is £4,406 per life-year saved (undiscontinued) to a worst case
of £10,291 per life-year saved (undiscontinued). Our base case estimate of cost-effectiveness
suggests that treating patients at high risk for CVD events with ramipril is likely
to be a good investment of NHS resources.
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