title: Cost-effectiveness analysis of nebivolol and metoprolol in essential hypertension: a pharmacoeconomic comparison of antihypertensive efficacy of beta blockers.
abstract: OBJECTIVE
  To estimate and compare the cost-effectiveness and safety of nebivolol with sustained-release metoprolol in reducing blood pressure by 1 mm of Hg per day in hypertensive patients.
  
  
  METHODS
  This was a prospective, randomized, open label, observational analysis of cost-effectiveness, in a questionnaire-based fashion to compare the cost of nebivolol (2.5 mg, 5 mg, 10 mg) and sustained released metoprolol succinate (25 mg, 50 mg, 100 mg) in hypertensive patients using either of the two drugs. A total of 60 newly detected drug naïve hypertensive patients were considered for the comparison, of which 30 patients were prescribed nebivolol and the other 30 were prescribed metoprolol succinate as per the recommended dosage. Based on the data, statistical analysis was carried out using GraphPad Prism 5 and MS Excel Spreadsheet 2007.
  
  
  RESULTS
  The cost of reducing 1 mm of Hg blood pressure per day with nebivolol was 0.60, 0.70, and 1.06 INR, whereas that of metoprolol succinate was 0.93, 1.18, and 1.25 INR at their respective equivalent doses, hence significantly lower with the nebivolol group as compared to the metoprolol group (P < 0.05).
  
  
  CONCLUSIONS
  This pharmacoeconomic analysis shows that nebivolol is more cost-effective as compared to metoprolol when the cost per reduction in blood pressure per day is considered. This may affect the patients economically during their long-term use of these molecules for the treatment of hypertension.
authors.affiliation: Shivrath Centre of Excellence in Clinical Research, Ahmedabad, India.
authors.forename: Rachna S
authors.initials: RS
authors.lastname: Patel
authors.affiliation: U. N. Mehta Institute of Cardiology and Research Centre, Ahmedabad, India.
authors.forename: Kamal H
authors.initials: KH
authors.lastname: Sharma
authors.affiliation: B. J. Medical College, Ahmedabad, Gujarat, India.
authors.forename: Nitisha A
authors.initials: NA
authors.lastname: Kamath
authors.affiliation: Shivrath Centre of Excellence in Clinical Research, Ahmedabad, India.
authors.forename: Nirav H
authors.initials: NH
authors.lastname: Patel
authors.affiliation: Shivrath Centre of Excellence in Clinical Research, Ahmedabad, India.
authors.forename: Ankita M
authors.initials: AM
authors.lastname: Thakkar
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001578:Benzopyrans / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003362:Cost-Benefit Analysis; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D017850:Economics, Pharmaceutical; D000075222:Essential Hypertension; D004983:Ethanolamines / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008790:Metoprolol / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D008875:Middle Aged; D000068577:Nebivolol; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D001578:Benzopyrans; D003692:Delayed-Action Preparations; D004983:Ethanolamines; D000068577:Nebivolol; D008790:Metoprolol
keywords: Cost-effectiveness; hypertension; metoprolol; nebivolol; pharmacoeconomics