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首页> 外文期刊>Value in health: the journal of the International Society for Pharmacoeconomics and Outcomes Research >Cost-utility analysis of eprosartan compared to enalapril in primary prevention and nitrendipine in secondary prevention in Europe--the HEALTH model.
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Cost-utility analysis of eprosartan compared to enalapril in primary prevention and nitrendipine in secondary prevention in Europe--the HEALTH model.

机译：在欧洲，EPROSARTAN与依那普利相比在一次预防中的成本效用分析和尼群地平在二次预防中的成本效用分析-健康模型。

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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 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 (Euro 24,036) followed by Belgium (Euro 17,863), the UK (Euro 16,364), Norway (Euro 13,834), Sweden (Euro 11,691) and Spain (Euro 7918). In a secondary prevention setting (eprosartan vs. nitrendipine) the highest costs per QALY gained have been observed in Germany (Euro 9136) followed by the UK (Euro 6008), Norway (Euro 1695), Sweden (Euro 907), Spain (Euro -2054) and Belgium (Euro -5767). CONCLUSIONS: Considering a Euro 30,000 willingness-to-pay threshold per QALY gained, eprosartan is cost-effective as compared to enalapril in primary prevention (patients >or=50 years old and a systolic blood pressure >or=160 mm Hg) and cost-effective as compared to nitrendipine in secondary prevention (all investigated patients).
机译：目的：根据随机对照试验的正面证据，研究依普罗沙坦与依那普利（一级预防）和尼群地平（二级预防）的成本-效用。方法：健康模型（高血压的特维滕生命经济评估）是一种面向对象的概率蒙特卡罗模拟模型。它将基于Framingham的风险计算与收缩压方法相结合，以根据最近的荟萃分析估算心血管和脑血管事件的相对风险降低。在二级预防中，根据MOSES研究的结果（“卒中后的发病率和死亡率–依普罗沙坦与尼替地平相比为二级预防，”）模拟了依普罗沙坦的其他风险降低。成本和公用事业费是从考虑到欧洲特定国家/地区的医疗支付者的角度从已发布的估算中得出的。结果：在一级预防中将依普罗沙坦与依那普利进行比较，其设定的每质量调整生命年（QALY）的平均成本在德国（24,036欧元）最高，其次是比利时（17,863欧元），英国（16,364欧元），挪威（13,834欧元） ），瑞典（11,691欧元）和西班牙（7918欧元）。在二级预防环境中（依普罗沙坦与尼群地平），在德国（9136欧元），其次是英国（6008欧元），挪威（1695欧元），瑞典（907欧元），西班牙（欧元），每个QALY获得的费用最高。 -2054）和比利时（欧洲-5767）。结论：考虑到获得的每QALY 30,000欧元的支付意愿阈值，在依普罗坦的一级预防（患者>或= 50岁且收缩压>或= 160 mm Hg）中，依普沙坦比恩那普利更具成本效益与尼群地平相比在二级预防中有效（所有接受调查的患者）。

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