title: Health economic implications of irbesartan treatment versus standard blood pressure control in patients with type 2 diabetes, hypertension and renal disease: a Hungarian analysis.
abstract: To perform a health economic analysis on treatment with irbesartan in patients with type 2 diabetes and hypertension. A Markov model was adapted to the Hungarian setting to simulate renal deterioration from the development of microalbuminuria to nephropathy, doubling of serum creatinine, end-stage renal disease (ESRD) and all-cause mortality. Outcomes for two treatments were evaluated: (1) a placebo regimen of standard antihypertensive medications, and (2) the addition of irbesartan 300 mg administered daily, with both treatment initiated after developing microalbuminuria. Outcomes were discounted at 5% annually to correspond with national guidelines. Treatment with irbesartan was estimated to improve undiscounted life expectancy by 0.98 +/- 0.05 years, reduce the cumulative incidence of ESRD by 7.5 +/- 0.4%, and reduce lifetime costs by Hungarian Forints (HUF) 519,993 +/- 70,814, compared to placebo. Irbesartan was projected to improved life expectancy and reduce costs compared to placebo in the Hungarian setting in hypertensive patients with type 2 diabetes and microalbuminuria.
authors.affiliation: CORE, Center for Outcomes Research, A Unit of IMS Health, Gewerbestrasse 25, 4123, Allschwil/Basel, Switzerland.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Palmer
authors.forename: William J
authors.initials: WJ
authors.lastname: Valentine
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Ray
authors.forename: Stephane
authors.initials: S
authors.lastname: Roze
authors.forename: Noemi
authors.initials: N
authors.lastname: Muszbek
mesh_terms: D000419:Albuminuria / Q000503:physiopathology; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D003365:Costs and Cost Analysis; D003924:Diabetes Mellitus, Type 2; D004359:Drug Therapy, Combination; D006801:Humans; D006814:Hungary; D006973:Hypertension / Q000188:drug therapy*; D000077405:Irbesartan; D007676:Kidney Failure, Chronic / Q000503:physiopathology; D008017:Life Expectancy; D008390:Markov Chains; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D013777:Tetrazoles / Q000008:administration & dosage / Q000191:economics* / Q000627:therapeutic use
chemical_list: D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D013777:Tetrazoles; D000077405:Irbesartan