Cost-Utility Analysis of Eprosartan Compared to Enalapril in Primary Prevention and Nitrendipine in Secondary Prevention in Europe-The HEALTH Model

Schwander B, Gradl B, Zoellner Y, Lindgren P, Diener H-C, Lueders S, Schrader J, Antonanzas Villar F, Greiner W, Jonsson B (2009)
VALUE IN HEALTH 12(6): 857-871.

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Objective: To investigate the cost-utility of eprosartan versus enalapril (primary prevention) and versus nitrendipine (secondary prevention) on the basis of head-to-head evidence from randomized controlled trials. Methods: The HEALTH model (Health Economic Assessment of Life with Teveten((R)) for Hypertension) is an object-oriented probabilistic Monte Carlo simulation model. It combines a Framingham-based risk calculation with a systolic blood pressure approach to estimate the relative risk reduction of cardiovascular and cerebrovascular events based on recent meta-analyses. In secondary prevention, an additional risk reduction is modeled for eprosartan according to the results of the MOSES study ("Morbidity and Mortality after Stroke-Eprosartan Compared to Nitrendipine for Secondary Prevention"). Costs and utilities were derived from published estimates considering European country-specific health-care payer perspectives. Results: Comparing eprosartan to enalapril in a primary prevention setting the mean costs per quality adjusted life year (QALY) gained were highest in Germany (24,036) followed by Belgium (17,863), the UK (16,364), Norway ( 13,834), Sweden ( 11,691) and Spain ( 7918). In a secondary prevention setting (eprosartan vs. nitrendipine) the highest costs per QALY gained have been observed in Germany (9136) followed by the UK (6008), Norway (1695), Sweden (907), Spain (-2054) and Belgium (-5767). Conclusions: Considering a 30,000 willingness-to-pay threshold per QALY gained, eprosartan is cost-effective as compared to enalapril in primary prevention (patients >= 50 years old and a systolic blood pressure >= 160 mm Hg) and cost-effective as compared to nitrendipine in secondary prevention (all investigated patients).
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Schwander B, Gradl B, Zoellner Y, et al. Cost-Utility Analysis of Eprosartan Compared to Enalapril in Primary Prevention and Nitrendipine in Secondary Prevention in Europe-The HEALTH Model. VALUE IN HEALTH. 2009;12(6):857-871.
Schwander, B., Gradl, B., Zoellner, Y., Lindgren, P., Diener, H. - C., Lueders, S., Schrader, J., et al. (2009). Cost-Utility Analysis of Eprosartan Compared to Enalapril in Primary Prevention and Nitrendipine in Secondary Prevention in Europe-The HEALTH Model. VALUE IN HEALTH, 12(6), 857-871.
Schwander, B., Gradl, B., Zoellner, Y., Lindgren, P., Diener, H. - C., Lueders, S., Schrader, J., Antonanzas Villar, F., Greiner, W., and Jonsson, B. (2009). Cost-Utility Analysis of Eprosartan Compared to Enalapril in Primary Prevention and Nitrendipine in Secondary Prevention in Europe-The HEALTH Model. VALUE IN HEALTH 12, 857-871.
Schwander, B., et al., 2009. Cost-Utility Analysis of Eprosartan Compared to Enalapril in Primary Prevention and Nitrendipine in Secondary Prevention in Europe-The HEALTH Model. VALUE IN HEALTH, 12(6), p 857-871.
B. Schwander, et al., “Cost-Utility Analysis of Eprosartan Compared to Enalapril in Primary Prevention and Nitrendipine in Secondary Prevention in Europe-The HEALTH Model”, VALUE IN HEALTH, vol. 12, 2009, pp. 857-871.
Schwander, B., Gradl, B., Zoellner, Y., Lindgren, P., Diener, H.-C., Lueders, S., Schrader, J., Antonanzas Villar, F., Greiner, W., Jonsson, B.: Cost-Utility Analysis of Eprosartan Compared to Enalapril in Primary Prevention and Nitrendipine in Secondary Prevention in Europe-The HEALTH Model. VALUE IN HEALTH. 12, 857-871 (2009).
Schwander, Bjoern, Gradl, Birgit, Zoellner, York, Lindgren, Peter, Diener, Hans-Christoph, Lueders, Stephan, Schrader, Joachim, Antonanzas Villar, Fernando, Greiner, Wolfgang, and Jonsson, Bengt. “Cost-Utility Analysis of Eprosartan Compared to Enalapril in Primary Prevention and Nitrendipine in Secondary Prevention in Europe-The HEALTH Model”. VALUE IN HEALTH 12.6 (2009): 857-871.
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