title: [Theoretical model of a cost-effectiveness analysis of combined enalapril-nitrendipine therapy for treating hypertension].
abstract: OBJECTIVE
  Cost-effectiveness analysis of combined enalapril-nitrendipine therapy (E/N), as second-line therapy for light or moderate hypertension.
  
  
  METHODS
  Theoretical model of cost-effectiveness, based on the norms of hypertension treatment in primary care, the considered view of a panel of experts and the direct costs of health resources and purchase of medication.
  
  
  METHODS
  Spanish National Health system.
  
  
  METHODS
  Simulation of 1000 patients with hypertension, with a time horizon of one year.
  
  
  METHODS
  After a prior failure of the first-line treatment with either enalapril or nitrendipine, an evaluation was made of the possibilities of increasing dosage of the first-line treatment, changing the drug or administering the E/N combination.
  
  
  METHODS
  The likelihoods, in the primary care context, of controlling diastolic pressure, of abandonment and of using the two strategies or not were measured, as were the use of health resources in each situation, and costs of resource use and of medication.
  
  
  RESULTS
  The cost-effectiveness quotient of the combined E/N treatment was consistently more efficient than the increase in dose or change to another drug. This was so, whether the treatment was started with enalapril (301.06 euros vs 337.97 euros and 588.42 euros) or with nitrendipine (331.5 euros vs 469.88 euros and 579.76 euros).
  
  
  CONCLUSIONS
  Combined therapy (E/N) is, on the basis of the assumptions made in the model, an efficient therapy option. Therefore, it can be recommended for prescription.
authors.affiliation: Soikos, SL. Barcelona. España. Departamento de Economía y Empresa. Universidad de La Rioja. Logroño. España.
authors.forename: F
authors.initials: F
authors.lastname: Antoñanzas
authors.forename: M
authors.initials: M
authors.lastname: Velasco
authors.forename: I
authors.initials: I
authors.lastname: Abbas
authors.forename: C
authors.initials: C
authors.lastname: Pontes
authors.forename: J
authors.initials: J
authors.lastname: Delgadillo
authors.forename: M
authors.initials: M
authors.lastname: Terán
mesh_terms: D003362:Cost-Benefit Analysis; D004656:Enalapril; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008962:Models, Theoretical; D009568:Nitrendipine
chemical_list: D004656:Enalapril; D009568:Nitrendipine
vernacular_title: Modelo teórico de análisis coste-efectividad de la terapia combinada de enalapril-nitrendipino en el tratamiento de la hipertensión arterial.