title: The cost-effectiveness of irbesartan in the treatment of hypertensive patients with type 2 diabetic nephropathy.
abstract: BACKGROUND
  End-stage renal disease (ESRD)-related health care costs are substantial. Improving clinical outcomes in patients at risk of progression to ESRD could lead to considerable health care savings.
  
  
  OBJECTIVE
  We estimated the cost-effectiveness of irbesartan compared with placebo or amlodipine in the treatment of patients with type 2 diabetes mellitus, hypertension, and overt nephropathy.
  
  
  METHODS
  Three treatments for hypertension patients with type 2 diabetes mellitus and nephropathy were assessed: (1) irbesartan, (2) amlodipine, and (3) placebo. A Markov model was developed based on primary data from the Irbesartan in Diabetic Nephropathy Trial and the United States Renal Data System. Projected survival and costs were compared for each treatment at 3-, 10-, and 25-year time horizons. Different assumptions of treatment benefits and costs were tested with use of sensitivity analyses.
  
  
  RESULTS
  At 10 and 25 years, the model projected irbesartan to be both the least costly and most effective (ie, demonstrating a survival advantage) strategy. At 25
authors.affiliation: Rush-Presbyterian St. Luke's Medical Center, Chicago, Illinois, USA. rrodby@mindsring.com
authors.forename: Roger A
authors.initials: RA
authors.lastname: Rodby
authors.forename: Chion Fang
authors.initials: CF
authors.lastname: Chiou
authors.forename: Jeff
authors.initials: J
authors.lastname: Borenstein
authors.forename: Allison
authors.initials: A
authors.lastname: Smitten
authors.forename: Nishan
authors.initials: N
authors.lastname: Sengupta
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Palmer
authors.forename: Stéphane
authors.initials: S
authors.lastname: Roze
authors.forename: Lieven
authors.initials: L
authors.lastname: Annemans
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Simon
authors.forename: Roland S
authors.initials: RS
authors.lastname: Chen
authors.forename: Edmund J
authors.initials: EJ
authors.lastname: Lewis
mesh_terms: D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000191:economics / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000191:economics* / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003928:Diabetic Nephropathies / Q000150:complications*; D005260:Female; D017048:Health Care Costs; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000191:economics*; D000077405:Irbesartan; D008017:Life Expectancy; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D013777:Tetrazoles / Q000191:economics* / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D013777:Tetrazoles; D017311:Amlodipine; D000077405:Irbesartan