Irbesartan is projected to be cost and life saving in a Spanish setting for treatment of patients with type 2 diabetes, hypertension, and microalbuminuria

Kidney Int Suppl. 2005 Jan;(93):S52-4. doi: 10.1111/j.1523-1755.2005.09312.x.

Abstract

Objectives: The purpose of this study was to project the cumulative incidence of end-stage renal disease (ESRD), life expectancy, and costs in a Spanish setting of treating patients with diabetes, hypertension, and microalbuminuria with either standard hypertension treatment alone or standard hypertension treatment plus irbesartan 300 mg daily.

Methods: A peer-reviewed, published Markov model that simulated progression from microalbuminuria to nephropathy, doubling of serum creatinine, ESRD, and all-cause mortality in patients with hypertension, type 2 diabetes, and microalbuminuria was adapted to a Spanish setting. Two strategies were compared: (1) irbesartan versus (2) standard hypertension care with comparable blood pressure control; both began in diabetic hypertensive subjects with microalbuminuria. Cumulative incidence of ESRD, costs, and life expectancy were projected for a hypothetical cohort of 1000 subjects. Future costs and life expectancy were discounted at 3% yearly. A 25-year time horizon and third party payer perspective were used.

Results: When compared to standard blood pressure control, irbesartan was projected to reduce the cumulative incidence of ESRD from (mean +/- standard deviation) 24 +/- 1% to 9 +/- 2%, save 11,082 +/- 2,996 euro, and add 1.40 +/- 0.27 life years per treated patient. The superiority of irbesartan over standard care was robust under a wide range of plausible assumptions.

Conclusion: Treating patients with hypertension, microalbuminuria, and type 2 diabetes with irbesartan was projected to reduce the incidence of ESRD, extend life, and reduce costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albuminuria / economics
  • Albuminuria / epidemiology*
  • Albuminuria / etiology*
  • Antihypertensive Agents / economics
  • Antihypertensive Agents / therapeutic use*
  • Biphenyl Compounds / economics
  • Biphenyl Compounds / therapeutic use*
  • Blood Pressure / physiology
  • Cost Savings
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / economics
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / economics
  • Hypertension / epidemiology*
  • Irbesartan
  • Life Expectancy
  • Markov Chains
  • Spain / epidemiology
  • Tetrazoles / economics
  • Tetrazoles / therapeutic use*

Substances

  • Antihypertensive Agents
  • Biphenyl Compounds
  • Tetrazoles
  • Irbesartan