Key result
Early irbesartan initiated in patients with microalbuminuria improved life expectancy by 0.78 years and reduced lifetime costs by US$7,603 compared with standard hypertensive treatment.
Why the study?
Does early irbesartan, late irbesartan, or amlodipine improve life expectancy and reduce costs compared to standard hypertensive treatment in patients with diabetes, hypertension, and microalbuminuria?
Does early irbesartan, late irbesartan, or amlodipine improve life expectancy and reduce costs compared to standard hypertensive treatment in patients with diabetes, hypertension, and microalbuminuria?
Early initiation of irbesartan in hypertensive diabetic patients with microalbuminuria is projected to extend life, reduce ESRD incidence, and save costs in Taiwan.
May support early irbesartan consideration in Taiwan; leaves open prospective validation beyond modeling.
SummaryThis modelling study aimed to evaluate the long-term cost effectiveness of four treatment strategies: early irbesartan; late irbesartan; amlodipine; and standard hypertensive treatment in patients with diabetes, hypertension and microalbuminuria in Taiwan. A Markov model was used to project costs and clinical outcomes over lifetimes.Early irbesartan (initiated in microalbuminuric patients) yielded the largest improvements in life expectancy (0.78 years) compared with standard treatment. Late irbesartan and amlodipine (started in patients with overt nephropathy) also resulted in slight improvements in life expectancy (0.109 and 0.001 years, respectively). Both early and late irbesartan reduced lifetime costs compared with control (US$7,603 and US$3,233, respectively), whereas amlodipine increased lifetime costs by US$300. Improvements were attributed to reductions in the cumulative incidence of end-stage renal disease with early use of irbesartan.Treating hypertensive diabetic patients with early irbesartan was projected to be life extending and cost saving, and to reduce the incidence of ESRD in Taiwan.
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Yang et al. (2007) studied Diabetes, hypertension and microalbuminuria. Early irbesartan vs. Standard hypertensive treatment was evaluated on Life expectancy and lifetime costs. Early irbesartan initiated in patients with microalbuminuria improved life expectancy by 0.78 years and reduced lifetime costs by US$7,603 compared with standard hypertensive treatment.
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