title: Pharmacoeconomic consequences of amlodipine besylate therapy in patients undergoing PTCA.
abstract: In Italy, revascularization interventions increased from 44,600 in 1996 to more than 100,000 in 2001. In particular, the occurrence of percutaneous transluminal coronary angioplasty (PTCA) increased from 239 cases per million population in 1994 to about 1300 cases per million population in 2001. This trend has caused a concomitant increase in revascularization costs, which have doubled in few years, rising from Euro 421 millions in 1996 to Euro 850 millions in 2001. In 2001, PTCA amounted to 55% of total cost of revascularizations. The aim of this study was to assess the pharmacoeconomic consequences of amlodipine besylate therapy administered in patients at high risk of restenosis after PTCA. We conducted a cost-effectiveness analysis comparing therapy with amlodipine besylate added to standard care versus standard care alone. Information on clinical outcomes was drawn from the Coronary Angioplasty Amlodipine Restenosis Study (CAPARES). Medical costs were estimated with reference to drug therapy and hospitalizations for coronary events and revascularization procedures. The study was conducted from the perspective of the Italian third party payer (National Health Service). The analysis was applied to a time horizon of 4 months. Amlodipine besylate resulted less expensive and more effective than standard care. It reduced mortality, morbidity for coronary reasons and the need of revascularization procedures. The cost per 1000 patients was estimated at Euro 1,166,000 in the placebo and Euro 950,000 in the amlodipine besylate group, resulting into a cost saving of Euro 216,000, that is 18.5% of total cost of standard care. Results are sensitive to the cost of amlodipine besylate and the cost of hospitalizations, but therapy with amlodipine besylate resulted dominant even in the most unfavorable hypothesis.
authors.affiliation: Centro di Farmacoeconomia, Facoltà di Farmacia, Università degli Studi di Milano, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Rossetti
authors.forename: Simona
authors.initials: S
authors.lastname: De Portu
authors.forename: Enrica
authors.initials: E
authors.lastname: Menditto
authors.forename: Luciana
authors.initials: L
authors.lastname: Scalone
authors.forename: Silvia
authors.initials: S
authors.lastname: Bustacchini
authors.forename: Claudio
authors.initials: C
authors.lastname: Cricelli
authors.forename: Lorenzo Giovanni
authors.initials: LG
authors.lastname: Mantovani
mesh_terms: D017311:Amlodipine / Q000191:economics* / Q000627:therapeutic use; D015906:Angioplasty, Balloon, Coronary / Q000191:economics* / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000191:economics* / Q000628:therapy; D023903:Coronary Restenosis / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
chemical_list: D017311:Amlodipine