Key result
Generic calcium channel blockers are the most cost-effective first-line antihypertensive treatment compared to no treatment across all age groups, though sensitivity analyses show considerable uncertainty.
Why the study?
Are generic antihypertensive drugs cost-effective compared to no treatment for the primary prevention of cardiovascular disease in patients with asymptomatic hypertension?
Are generic antihypertensive drugs cost-effective compared to no treatment for the primary prevention of cardiovascular disease in patients with asymptomatic hypertension?
Generic antihypertensive drugs are cost-effective for primary CVD prevention, though the optimal first-line class remains uncertain from a health economics perspective.
Generic CCBs may be most cost-effective first-line antihypertensives versus no treatment; leaves optimal class selection open amid modeling uncertainty.
BACKGROUND: Hypertension is one of the leading causes of cardiovascular disease (CVD). A range of antihypertensive drugs exists, and their prices vary widely mainly due to patent rights. The objective of this study was to explore the cost-effectiveness of different generic antihypertensive drugs as first, second and third choice for primary prevention of cardiovascular disease. METHODS: We used the Norwegian Cardiovascular Disease model (NorCaD) to simulate the cardiovascular life of patients from hypertension without symptoms until they were all dead or 100 years old. The risk of CVD events and costs were based on recent Norwegian sources. RESULTS: In single-drug treatment, all antihypertensives are cost-effective compared to no drug treatment. In the base-case analysis, the first, second and third choice of antihypertensive were calcium channel blocker, thiazide and angiotensin-converting enzyme inhibitor. However the sensitivity and scenario analyses indicated considerable uncertainty in that angiotensin receptor blockers as well as, angiotensin-converting enzyme inhibitors, beta blockers and thiazides could be the most cost-effective antihypertensive drugs. CONCLUSIONS: Generic antihypertensives are cost-effective in a wide range of risk groups. There is considerable uncertainty, however, regarding which drug is the most cost-effective.
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Wisløff et al. (2012) studied Hypertension (primary prevention of cardiovascular disease). Generic antihypertensive drugs (calcium channel blockers) vs. No treatment was evaluated on Incremental net health benefit (INHB) and Incremental cost-effectiveness ratio (ICER). Generic calcium channel blockers are the most cost-effective first-line antihypertensive treatment compared to no treatment across all age groups, though sensitivity analyses show considerable uncertainty.
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