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Economic Evaluation of ASCOT-BPLA: Antihypertensive treatment with an amlodipine-based regimen is cost-effective compared to an atenolol-based regimen
  1. Peter Lindgren (peter.lindgren{at}i3innovus.com)
  1. i3innovus, Sweden
    1. Martin Buxton (martin.buxton{at}brunel.ac.uk)
    1. Brunel University, United Kingdom
      1. Thomas Kahan
      1. Karolinska Institutet, Sweden
        1. Neil R Poulter (n.poulter{at}imperial.ac.uk)
        1. Imperial College London, United Kingdom
          1. Björn Dahlöf (bjorn.dahlof{at}a-plusscience.com)
          1. Sahlgrenska University Hospital/Östra, Sweden
            1. Peter S Sever (p.sever{at}imperial.ac.uk)
            1. Imperial College London, United Kingdom
              1. Hans Wedel (hans.wedel{at}biostat.se)
              1. Nordic School of Public Health, Sweden
                1. Bengt Jönsson (bengt.jonsson{at}hhs.se)
                1. Stockholm School of Economics, Sweden

                  Abstract

                  Objective To assess the cost-effectiveness of an amlodipine-based strategy compared to an atenolol-based strategy in the treatment of hypertension in the UK and Sweden.

                  Design A prospective, randomized trial complemented with a Markov model to assess long-term costs and health effects.

                  Setting Primary care.

                  Patients Patients with moderate hypertension and three or more additional risk factors.

                  Interventions Amlodipine 5-10 mg with perindopril 4-8 mg added as needed or atenolol 50-100 mg adding bendroflumethiazide 1.25–2.5 mg and potassium as needed

                  Main outcome measures Cost per cardiovascular event and procedure avoided, and cost per quality-adjusted life year gained.

                  Results In the UK, the cost to avoid one cardiovascular event or procedure would be 18 965 €, and the cost to gain one quality-adjusted life year would be 21 875 €. The corresponding figures for Sweden were 13 210 € and 16 856 €.

                  Conclusions Compared to the thresholds applied by NICE and in the Swedish National Board of Health and Welfare's Guidelines for Cardiac Care, an amlodipine-based regimen is cost-effective for the treatment of hypertension, compared to an atenolol-based regimen in the population studied.

                  • amlodipine
                  • atenolol
                  • cost-effectiveness
                  • hypertension
                  • primary prevention

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