Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus: An ADVANCE trial-based analysis

Paul P. Glasziou, Philip Clarke, Jan Alexander, Mohana Rajmokan, Elaine Beller, Mark Woodward, John Chalmers, Neil Poulter, Anushka Patel

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Abstract

Objective: to determine the cost-effectiveness of routine administration, irrespective of blood pressure (BP), of a fixed-dose combination of perindopril and indapamide to patients with type 2 diabetes mellitus

Design, setting and participants: Prospective cost-effectiveness analysis within the Action in Diabetes and Vascular Disease Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial, an international, multicentre, randomised controlled trial of 11 140 participants with type 2 diabetes randomly allocated to receive perindopril plus indapamide (4 mg-1 25 mg/day) or placebo

Main outcome measures: Health-related quality-of-life measured by the EuroQol-5D, resource utilisation, and cost-effectiveness (cost per death averted at 4 3 years' average follow-up, and estimated cost per life-year gained, by extrapolation)

Results: The mean health-related quality-of-life score of survivors was 080 (on a 0-1 scale [death to full health]), with no difference between treatment groups Active treatment reduced hospital admissions for coronary heart disease and coronary revascularisation by 5% For the Australian participants, perindopril indapamide cost A$1368 per patient during the trial period, but reduced total hospitalisation costs by A$410 and other medication costs (mainly other BP-lowering drugs) by A$332 The absolute reduction in all-cause mortality for the active treatment group was 1 1%, giving a cost per life saved of A$49200 Lifetime extrapolation gave an estimated cost per life-year saved of A$10 040 (discounted at 5% per year)

Conclusion: The combination of perindopril and indapamide in patients with type 2 diabetes appears to be cost-effective

Original languageEnglish
Pages (from-to)320-324
Number of pages6
JournalMedical Journal of Australia
Volume193
Issue number6
Publication statusPublished - 20 Sep 2010

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Indapamide
Perindopril
Type 2 Diabetes Mellitus
Cost-Benefit Analysis
Blood Pressure
Costs and Cost Analysis
perindopril drug combination indapamide
Quality of Life
Gliclazide
Vascular Diseases
Multicenter Studies
Coronary Disease
Survivors
Hospitalization
Therapeutics
Randomized Controlled Trials
Outcome Assessment (Health Care)
Mortality

Cite this

Glasziou, Paul P. ; Clarke, Philip ; Alexander, Jan ; Rajmokan, Mohana ; Beller, Elaine ; Woodward, Mark ; Chalmers, John ; Poulter, Neil ; Patel, Anushka. / Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus : An ADVANCE trial-based analysis. In: Medical Journal of Australia. 2010 ; Vol. 193, No. 6. pp. 320-324.
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abstract = "Objective: to determine the cost-effectiveness of routine administration, irrespective of blood pressure (BP), of a fixed-dose combination of perindopril and indapamide to patients with type 2 diabetes mellitusDesign, setting and participants: Prospective cost-effectiveness analysis within the Action in Diabetes and Vascular Disease Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial, an international, multicentre, randomised controlled trial of 11 140 participants with type 2 diabetes randomly allocated to receive perindopril plus indapamide (4 mg-1 25 mg/day) or placeboMain outcome measures: Health-related quality-of-life measured by the EuroQol-5D, resource utilisation, and cost-effectiveness (cost per death averted at 4 3 years' average follow-up, and estimated cost per life-year gained, by extrapolation)Results: The mean health-related quality-of-life score of survivors was 080 (on a 0-1 scale [death to full health]), with no difference between treatment groups Active treatment reduced hospital admissions for coronary heart disease and coronary revascularisation by 5{\%} For the Australian participants, perindopril indapamide cost A$1368 per patient during the trial period, but reduced total hospitalisation costs by A$410 and other medication costs (mainly other BP-lowering drugs) by A$332 The absolute reduction in all-cause mortality for the active treatment group was 1 1{\%}, giving a cost per life saved of A$49200 Lifetime extrapolation gave an estimated cost per life-year saved of A$10 040 (discounted at 5{\%} per year)Conclusion: The combination of perindopril and indapamide in patients with type 2 diabetes appears to be cost-effective",
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Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus : An ADVANCE trial-based analysis. / Glasziou, Paul P.; Clarke, Philip; Alexander, Jan; Rajmokan, Mohana; Beller, Elaine; Woodward, Mark; Chalmers, John; Poulter, Neil; Patel, Anushka.

In: Medical Journal of Australia, Vol. 193, No. 6, 20.09.2010, p. 320-324.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus

T2 - An ADVANCE trial-based analysis

AU - Glasziou, Paul P.

AU - Clarke, Philip

AU - Alexander, Jan

AU - Rajmokan, Mohana

AU - Beller, Elaine

AU - Woodward, Mark

AU - Chalmers, John

AU - Poulter, Neil

AU - Patel, Anushka

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Y1 - 2010/9/20

N2 - Objective: to determine the cost-effectiveness of routine administration, irrespective of blood pressure (BP), of a fixed-dose combination of perindopril and indapamide to patients with type 2 diabetes mellitusDesign, setting and participants: Prospective cost-effectiveness analysis within the Action in Diabetes and Vascular Disease Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial, an international, multicentre, randomised controlled trial of 11 140 participants with type 2 diabetes randomly allocated to receive perindopril plus indapamide (4 mg-1 25 mg/day) or placeboMain outcome measures: Health-related quality-of-life measured by the EuroQol-5D, resource utilisation, and cost-effectiveness (cost per death averted at 4 3 years' average follow-up, and estimated cost per life-year gained, by extrapolation)Results: The mean health-related quality-of-life score of survivors was 080 (on a 0-1 scale [death to full health]), with no difference between treatment groups Active treatment reduced hospital admissions for coronary heart disease and coronary revascularisation by 5% For the Australian participants, perindopril indapamide cost A$1368 per patient during the trial period, but reduced total hospitalisation costs by A$410 and other medication costs (mainly other BP-lowering drugs) by A$332 The absolute reduction in all-cause mortality for the active treatment group was 1 1%, giving a cost per life saved of A$49200 Lifetime extrapolation gave an estimated cost per life-year saved of A$10 040 (discounted at 5% per year)Conclusion: The combination of perindopril and indapamide in patients with type 2 diabetes appears to be cost-effective

AB - Objective: to determine the cost-effectiveness of routine administration, irrespective of blood pressure (BP), of a fixed-dose combination of perindopril and indapamide to patients with type 2 diabetes mellitusDesign, setting and participants: Prospective cost-effectiveness analysis within the Action in Diabetes and Vascular Disease Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial, an international, multicentre, randomised controlled trial of 11 140 participants with type 2 diabetes randomly allocated to receive perindopril plus indapamide (4 mg-1 25 mg/day) or placeboMain outcome measures: Health-related quality-of-life measured by the EuroQol-5D, resource utilisation, and cost-effectiveness (cost per death averted at 4 3 years' average follow-up, and estimated cost per life-year gained, by extrapolation)Results: The mean health-related quality-of-life score of survivors was 080 (on a 0-1 scale [death to full health]), with no difference between treatment groups Active treatment reduced hospital admissions for coronary heart disease and coronary revascularisation by 5% For the Australian participants, perindopril indapamide cost A$1368 per patient during the trial period, but reduced total hospitalisation costs by A$410 and other medication costs (mainly other BP-lowering drugs) by A$332 The absolute reduction in all-cause mortality for the active treatment group was 1 1%, giving a cost per life saved of A$49200 Lifetime extrapolation gave an estimated cost per life-year saved of A$10 040 (discounted at 5% per year)Conclusion: The combination of perindopril and indapamide in patients with type 2 diabetes appears to be cost-effective

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JF - Medical Journal of Australia

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