Health economic implications of irbesartan treatment versus standard blood pressure control in patients with type 2 diabetes, hypertension and renal disease: a Hungarian analysis

Eur J Health Econ. 2007 Jun;8(2):161-8. doi: 10.1007/s10198-006-0033-2. Epub 2007 Jan 20.

Abstract

To perform a health economic analysis on treatment with irbesartan in patients with type 2 diabetes and hypertension. A Markov model was adapted to the Hungarian setting to simulate renal deterioration from the development of microalbuminuria to nephropathy, doubling of serum creatinine, end-stage renal disease (ESRD) and all-cause mortality. Outcomes for two treatments were evaluated: (1) a placebo regimen of standard antihypertensive medications, and (2) the addition of irbesartan 300 mg administered daily, with both treatment initiated after developing microalbuminuria. Outcomes were discounted at 5% annually to correspond with national guidelines. Treatment with irbesartan was estimated to improve undiscounted life expectancy by 0.98 +/- 0.05 years, reduce the cumulative incidence of ESRD by 7.5 +/- 0.4%, and reduce lifetime costs by Hungarian Forints (HUF) 519,993 +/- 70,814, compared to placebo. Irbesartan was projected to improved life expectancy and reduce costs compared to placebo in the Hungarian setting in hypertensive patients with type 2 diabetes and microalbuminuria.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albuminuria / physiopathology
  • Antihypertensive Agents / administration & dosage
  • Antihypertensive Agents / economics*
  • Antihypertensive Agents / therapeutic use
  • Biphenyl Compounds / administration & dosage
  • Biphenyl Compounds / economics*
  • Biphenyl Compounds / therapeutic use
  • Cohort Studies
  • Comorbidity
  • Costs and Cost Analysis
  • Diabetes Mellitus, Type 2*
  • Drug Therapy, Combination
  • Humans
  • Hungary
  • Hypertension / drug therapy*
  • Irbesartan
  • Kidney Failure, Chronic* / physiopathology
  • Life Expectancy
  • Markov Chains
  • Middle Aged
  • Outcome Assessment, Health Care
  • Tetrazoles / administration & dosage
  • Tetrazoles / economics*
  • Tetrazoles / therapeutic use

Substances

  • Antihypertensive Agents
  • Biphenyl Compounds
  • Tetrazoles
  • Irbesartan