[Cost-effectiveness analysis of Ramipril treatment of patients at high-risk of cardiovascular events in Spain].
OBJECTIVE
The cost-effectiveness of adding ramipril to the regular treatment of patients at high risk of suffering cardiovascular events was calculated.


METHODS
A retrospective pharmacoeconomic model was used. The clinical data were obtained from a randomized clinical trial of 9,297 patients (the HOPE study). Information about resource use and the associated costs was obtained from Spanish sources. The analysis was undertaken from the perspective of the National Health System, focusing on drug costs and the primary and secondary complications of cardiovascular events.


RESULTS
The incremental cost per life-year gained in the base case was 10,329 euros (6% discount rate). A sensitivity analysis showed that the results were more sensitive to changes in estimated post-trial life expectancy than to any other variable. The estimated number of cases of myocardial infarction, stroke, or cardiovascular death prevented in five years ranged from 19,000 to 39,000.


CONCLUSIONS
The addition of Ramipril to the conventional treatment of patients at high cardiovascular risk is cost-effective and less expensive per life-year gained than several treatments currently financed by the Spanish National Health System.
Hart
W M
WM
EcoStat Consulting Group, San Sebastián.
Rubio-Terrés
C
C
Margalet Fernández
I
I
González Juanatey
J R
JR
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000191:economics* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D017850:Economics, Pharmaceutical; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D018803:Models, Economic; D017257:Ramipril / Q000191:economics* / Q000627:therapeutic use; D012189:Retrospective Studies; D013030:Spain
D000806:Angiotensin-Converting Enzyme Inhibitors; D017257:Ramipril