Key result
Nebivolol was significantly more cost-effective than metoprolol succinate for reducing blood pressure, with a lower cost per 1 mm Hg reduction per day (0.60-1.06 INR vs 0.93-1.25 INR; P < 0.05).
Why the study?
Does nebivolol improve cost-effectiveness of blood pressure reduction compared to metoprolol in newly detected drug naïve hypertensive patients?
RCT (n=60)
open label
randomized
Does nebivolol improve cost-effectiveness of blood pressure reduction compared to metoprolol in newly detected drug naïve hypertensive patients?
Nebivolol is more cost-effective than metoprolol succinate for reducing blood pressure in newly diagnosed hypertensive patients.
Answers are grounded in this paper and cite their sources.
Supports preferring nebivolol over metoprolol for initial BP control in cost-sensitive settings; extends comparative cost-effectiveness data for beta-blockers in drug-naïve hypertension.
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. MATERIALS AND 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. RESULT: 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). CONCLUSION: 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.
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Sharma et al. (2014) conducted an RCT in essential hypertension (n=60). nebivolol vs. sustained released metoprolol succinate (25 mg, 50 mg, 100 mg) was evaluated on cost of reducing 1 mm of Hg blood pressure per day (p=< 0.05). Nebivolol was significantly more cost-effective than metoprolol succinate for reducing blood pressure, with a lower cost per 1 mm Hg reduction per day (0.60-1.06 INR vs 0.93-1.25 INR; P < 0.05).
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