What question did this study set out to answer?

June 9, 2015Cost Effectiveness and Resource AllocationOpen Access

Economic evaluation of a single-pill triple antihypertensive therapy with valsartan, amlodipine, and hydrochlorothiazide against its dual components

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Why the study?

Does a single-pill triple combination of valsartan, amlodipine, and hydrochlorothiazide improve cost-utility compared to dual combinations in patients with moderate to severe hypertension?

Population

Patients with moderate to severe hypertension

Comparison

Single-pill triple combination antihypertensive… vs Dual combinations of the same components

Design

Other

Follow-up

lifetime

Authors

PSPanagiotis StafylasAristotle University of Thessaloniki GKGeorgia KourlabaUniversity of Peloponnese MHM. HatzikouHellenic Open University

Discussion

Member takes

Implication

Triple combination may be cost-effective vs duals in moderate-severe hypertension; modeling leaves open need for prospective validation.

Key Points

To evaluate the cost-utility of a single-pill triple antihypertensive therapy containing valsartan, amlodipine, and hydrochlorothiazide compared to its corresponding dual components in moderate to severe hypertension.
Constructed an eight-state Markov decision model using annual cycles over a lifetime horizon with a 3.0% discount rate from a Greek third-party-payer perspective.
Extrapolated short-term blood pressure effects to long-term survival and quality-adjusted life-years (QALYs) using the Hellenic SCORE and Framingham risk equations.
Triple therapy yielded 12.76 QALYs at a lifetime cost of €16,525, compared to 12.64 QALYs (€15,480) for valsartan/amlodipine, 12.61 QALYs (€14,125) for valsartan/hydrochlorothiazide, and 12.38 QALYs (€11,690) for amlodipine/hydrochlorothiazide.
Incremental cost-effectiveness ratios were €8,690/QALY versus valsartan/amlodipine, €12,695/QALY versus amlodipine/hydrochlorothiazide, and €16,192/QALY versus valsartan/hydrochlorothiazide, with a >90% probability of cost-effectiveness at an €18,000/QALY threshold.

Structured PICO

Does a single-pill triple combination of valsartan, amlodipine, and hydrochlorothiazide improve cost-utility compared to dual combinations in patients with moderate to severe hypertension?

Population

Patients with moderate to severe hypertension

Intervention

Single-pill triple combination antihypertensive therapy containing valsartan, amlodipine, and hydrochlorothiazide

Comparator

Dual combinations of the same components (valsartan/amlodipine, valsartan/hydrochlorothiazide, and amlodipine/hydrochlorothiazide)

Outcome

Cost-utility (incremental cost-effectiveness ratio and quality-adjusted life-years [QALYs] saved)

Single-pill triple therapy with valsartan, amlodipine, and hydrochlorothiazide is a cost-effective choice for moderate to severe hypertension compared to dual combinations from a Greek third-party-payer perspective.

Cite This Study

Stafylas et al. (2015) studied this question.

synapsesocial.com/papers/6a76b72cf6b553d308adfe36 https://doi.org/10.1186/s12962-015-0036-x

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