title: An economic evaluation of antihypertensive therapies based on clinical trials.
abstract: OBJECTIVE
  Hypertension is a major issue in public health, and the financial costs associated with hypertension continue to increase. Cost-effectiveness studies focusing on antihypertensive drug combinations, however, have been scarce. The cost-effectiveness ratios of the traditional treatment (hydrochlorothiazide and atenolol) and the current treatment (losartan and amlodipine) were evaluated in patients with grade 1 or 2 hypertension (HT1-2). For patients with grade 3 hypertension (HT3), a third drug was added to the treatment combinations: enalapril was added to the traditional treatment, and hydrochlorothiazide was added to the current treatment.
  
  
  METHODS
  Hypertension treatment costs were estimated on the basis of the purchase prices of the antihypertensive medications, and effectiveness was measured as the reduction in systolic blood pressure and diastolic blood pressure (in mm Hg) at the end of a 12-month study period.
  
  
  RESULTS
  When the purchase price of the brand-name medication was used to calculate the cost, the traditional treatment presented a lower cost-effectiveness ratio [US$/mm Hg] than the current treatment in the HT1-2 group. In the HT3 group, however, there was no difference in cost-effectiveness ratio between the traditional treatment and the current treatment. The cost-effectiveness ratio differences between the treatment regimens maintained the same pattern when the purchase price of the lower-cost medication was used.
  
  
  CONCLUSIONS
  We conclude that the traditional treatment is more cost-effective (US$/mm Hg) than the current treatment in the HT1-2 group. There was no difference in cost-effectiveness between the traditional treatment and the current treatment for the HT3 group.
authors.affiliation: Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, Nephrology Division, Hypertension Unit, Brazil. rosanatsuji@hotmail.com
authors.forename: Rosana Lima Garcia
authors.initials: RL
authors.lastname: Tsuji
authors.forename: Giovanio Vieira da
authors.initials: GV
authors.lastname: Silva
authors.forename: Katia Coelho
authors.initials: KC
authors.lastname: Ortega
authors.forename: Otavio
authors.initials: O
authors.lastname: Berwanger
authors.forename: Decio
authors.initials: D
authors.lastname: Mion Júnior
mesh_terms: D017311:Amlodipine / Q000009:adverse effects / Q000191:economics*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000191:economics*; D001262:Atenolol / Q000009:adverse effects / Q000191:economics*; D001794:Blood Pressure / Q000187:drug effects; D016527:Drug Costs; D004359:Drug Therapy, Combination / Q000191:economics; D004656:Enalapril / Q000008:administration & dosage / Q000191:economics; D005260:Female; D006801:Humans; D006852:Hydrochlorothiazide / Q000009:adverse effects / Q000191:economics*; D006973:Hypertension / Q000145:classification / Q000188:drug therapy*; D019808:Losartan / Q000009:adverse effects / Q000191:economics*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
chemical_list: D000959:Antihypertensive Agents; D006852:Hydrochlorothiazide; D017311:Amlodipine; D001262:Atenolol; D004656:Enalapril; D019808:Losartan