The cost-effectiveness of hypertension pharmacotherapy in Serbia: A Markov model
Abstract
To date there is no Markov model to evaluate the cost-effectiveness of antihypertensive pharmacotherapies at national level in developing countries. The aim of our study was to evaluate different antihypertensives and determine their cost-effectiveness as mono therapy treatment in primary care in Serbia. We developed a Markov model to estimate quality-adjusted life years (QALY), lifetime costs and incremental cost-effectiveness of different antihypertensive medicines used in the clinical practice in Serbia (diuretic, beta blocker Ca channel blocker and ACE inhibitors) to strategy "no intervention". Cohort of 55-year-old patients with hypertension (systolic and diastolic blood pressure >= 140 and 90 mmHg), without cardiovascular complications was run through the model. Acute myocardial infarction, angina pectoris, heart failure, stroke, and total mortality were observed as outcomes. The time horizon was over a lifetime, and the perspective was that of a third-party payer Annual discount... rate of 5% was applied to all future costs and effects. The results showed small differences in QALY in strategies ACE inhibitor, beta blockers, and diuretic. The incremental cost-effectiveness ratio (ICER) for diuretic, compared to no intervention, was (sic)74.27/QALY. The ICER for beta blocker compared to diuretic was (sic)75.58/QALY. ACE inhibitor was extended dominated by diuretic and beta blocker, while Ca channel blocker had higher costs and less effectiveness compared to all previous strategies. The results of the probabilistic sensitivity analysis showed that application of antihypertensive therapy is cost-effective even at small values of willingness to pay. It could be concluded that for individuals aged 55 the diuretics are the most cost-effective strategy to start monotherapy of hypertension.
Keywords:
hypertension / cost-effectiveness / pharmacotherapy / Markov model / SerbiaSource:
Biotechnology & Biotechnological Equipment, 2012, 26, 3, 3066-3072Publisher:
- Taylor & Francis Ltd, Abingdon
Funding / projects:
DOI: 10.5504/BBEQ.2012.0009
ISSN: 1310-2818
WoS: 000305502300022
Scopus: 2-s2.0-84863206284
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Institution/Community
PharmacyTY - JOUR AU - Lakić, Dragana AU - Petrova, Guenka AU - Bogavac-Stanojević, Nataša AU - Jelić-Ivanović, Zorana AU - Kos, Mitja PY - 2012 UR - https://farfar.pharmacy.bg.ac.rs/handle/123456789/1730 AB - To date there is no Markov model to evaluate the cost-effectiveness of antihypertensive pharmacotherapies at national level in developing countries. The aim of our study was to evaluate different antihypertensives and determine their cost-effectiveness as mono therapy treatment in primary care in Serbia. We developed a Markov model to estimate quality-adjusted life years (QALY), lifetime costs and incremental cost-effectiveness of different antihypertensive medicines used in the clinical practice in Serbia (diuretic, beta blocker Ca channel blocker and ACE inhibitors) to strategy "no intervention". Cohort of 55-year-old patients with hypertension (systolic and diastolic blood pressure >= 140 and 90 mmHg), without cardiovascular complications was run through the model. Acute myocardial infarction, angina pectoris, heart failure, stroke, and total mortality were observed as outcomes. The time horizon was over a lifetime, and the perspective was that of a third-party payer Annual discount rate of 5% was applied to all future costs and effects. The results showed small differences in QALY in strategies ACE inhibitor, beta blockers, and diuretic. The incremental cost-effectiveness ratio (ICER) for diuretic, compared to no intervention, was (sic)74.27/QALY. The ICER for beta blocker compared to diuretic was (sic)75.58/QALY. ACE inhibitor was extended dominated by diuretic and beta blocker, while Ca channel blocker had higher costs and less effectiveness compared to all previous strategies. The results of the probabilistic sensitivity analysis showed that application of antihypertensive therapy is cost-effective even at small values of willingness to pay. It could be concluded that for individuals aged 55 the diuretics are the most cost-effective strategy to start monotherapy of hypertension. PB - Taylor & Francis Ltd, Abingdon T2 - Biotechnology & Biotechnological Equipment T1 - The cost-effectiveness of hypertension pharmacotherapy in Serbia: A Markov model VL - 26 IS - 3 SP - 3066 EP - 3072 DO - 10.5504/BBEQ.2012.0009 ER -
@article{ author = "Lakić, Dragana and Petrova, Guenka and Bogavac-Stanojević, Nataša and Jelić-Ivanović, Zorana and Kos, Mitja", year = "2012", abstract = "To date there is no Markov model to evaluate the cost-effectiveness of antihypertensive pharmacotherapies at national level in developing countries. The aim of our study was to evaluate different antihypertensives and determine their cost-effectiveness as mono therapy treatment in primary care in Serbia. We developed a Markov model to estimate quality-adjusted life years (QALY), lifetime costs and incremental cost-effectiveness of different antihypertensive medicines used in the clinical practice in Serbia (diuretic, beta blocker Ca channel blocker and ACE inhibitors) to strategy "no intervention". Cohort of 55-year-old patients with hypertension (systolic and diastolic blood pressure >= 140 and 90 mmHg), without cardiovascular complications was run through the model. Acute myocardial infarction, angina pectoris, heart failure, stroke, and total mortality were observed as outcomes. The time horizon was over a lifetime, and the perspective was that of a third-party payer Annual discount rate of 5% was applied to all future costs and effects. The results showed small differences in QALY in strategies ACE inhibitor, beta blockers, and diuretic. The incremental cost-effectiveness ratio (ICER) for diuretic, compared to no intervention, was (sic)74.27/QALY. The ICER for beta blocker compared to diuretic was (sic)75.58/QALY. ACE inhibitor was extended dominated by diuretic and beta blocker, while Ca channel blocker had higher costs and less effectiveness compared to all previous strategies. The results of the probabilistic sensitivity analysis showed that application of antihypertensive therapy is cost-effective even at small values of willingness to pay. It could be concluded that for individuals aged 55 the diuretics are the most cost-effective strategy to start monotherapy of hypertension.", publisher = "Taylor & Francis Ltd, Abingdon", journal = "Biotechnology & Biotechnological Equipment", title = "The cost-effectiveness of hypertension pharmacotherapy in Serbia: A Markov model", volume = "26", number = "3", pages = "3066-3072", doi = "10.5504/BBEQ.2012.0009" }
Lakić, D., Petrova, G., Bogavac-Stanojević, N., Jelić-Ivanović, Z.,& Kos, M.. (2012). The cost-effectiveness of hypertension pharmacotherapy in Serbia: A Markov model. in Biotechnology & Biotechnological Equipment Taylor & Francis Ltd, Abingdon., 26(3), 3066-3072. https://doi.org/10.5504/BBEQ.2012.0009
Lakić D, Petrova G, Bogavac-Stanojević N, Jelić-Ivanović Z, Kos M. The cost-effectiveness of hypertension pharmacotherapy in Serbia: A Markov model. in Biotechnology & Biotechnological Equipment. 2012;26(3):3066-3072. doi:10.5504/BBEQ.2012.0009 .
Lakić, Dragana, Petrova, Guenka, Bogavac-Stanojević, Nataša, Jelić-Ivanović, Zorana, Kos, Mitja, "The cost-effectiveness of hypertension pharmacotherapy in Serbia: A Markov model" in Biotechnology & Biotechnological Equipment, 26, no. 3 (2012):3066-3072, https://doi.org/10.5504/BBEQ.2012.0009 . .