Resource utilization implications of treatment were able to be assessed from appropriately reported clinical trial data.
OBJECTIVE
Published clinical trial data rarely allow assessment of the health care resource utilization implications of treatment. We give an example of how these can be assessed given appropriate tabulation of data.


METHODS
Data from a trial comparing long-acting nifedipine gastrointestinal therapeutic system to placebo in 7,665 patients with stable angina pectoris was analyzed.


RESULTS
Relative to placebo, nifedipine significantly increased mean cardiovascular (CV) event-free survival by 41 days but had no effect on mean survival. Per 100 years of follow-up, 78.1 patient-years of double-blind nifedipine administration reduced use of another calcium antagonist, an angiotensin converting enzyme inhibitor, an angiotensin receptor blocker, a diuretic and a cardiac glycoside by 1.54, 3.73, 2.63, 2.23, and 0.64 years, respectively, whereas 0.21 less hospitalization for overt heart failure, 0.47 less hospitalization for any stroke or transient ischemic attack, 0.8 less coronary angiogram, 0.38 less coronary bypass procedure, and 0.13 additional orthopedic procedure was required. Combining resource utilization with cost data for one particular hospital showed that one additional year of CV event-free survival costs an average additional euro 3,036 in the setting considered.


CONCLUSIONS
Appropriately tabulated clinical trial data allows clinicians to judge the resource utilization implications and economic effect of treatment decisions.
Poole-Wilson
Philip A
PA
Cardiac Medicine, Imperial College, Dovehouse Street, London SW3 6LY, UK.
Kirwan
Bridget-Anne
BA
Vokó
Zoltán
Z
de Brouwer
Sophie
S
Dunselman
Peter H J M
PH
van Dalen
Frederik J
FJ
Lubsen
Jacobus
J
D000787:Angina Pectoris / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D002121:Calcium Channel Blockers / Q000191:economics / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006295:Health Resources / Q000191:economics* / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000191:economics / Q000627:therapeutic use*; D016896:Treatment Outcome
D002121:Calcium Channel Blockers; D009543:Nifedipine