PCV35: COMPARABILITY OF PUBLISHED STUDIES ON COST-EFFECTIVENESS OF ANTIHYPERTENSIVE THERAPY: DO THE RESULTS HELP THE DECISION-MAKING PROCESS?

Abstract

OBJECTIVES: Cost-effectiveness studies can provide valuable information for decision-making processes, where limited resources need to be allocated across a variety of different treatments. However, it is argued that the current methods for conducting and reporting cost-effectiveness results for this purpose are sub-optimal. This literature review and analysis compares the most recent hypertension cost-effectiveness studies. The goal is to contribute information so that future cost-effectiveness studies of hypertension treatments will provide more optimal information for clinicians and other decision-makers for the choice of antihypertensive treatment. METHOD: A literature search of several databases for the years 1995?2000 was conducted using the following keywords: hypertension and cost-effectiveness and/or economics. RESULTS: The search resulted in 89 articles, of which only 11% (10 studies) were true pharmacoeconomic studies that contained actual data analysis. Of the 10 studies, the majority reported outcome measures in terms of cost per life year gained, but usually considered more than one outcome measure. Coronary heart diseases and stroke were the most consistent endpoints across the studies but the number and types of endpoints that were included differed significantly among the studies. Only two studies included within-clinical trial treatment effectiveness data, whereas the remaining studies modeled treatment effects from previously published trials. The projected cardiac event rates and life expectancy were most often derived and estimated from the Framingham study. Treatment costs were obtained from several different sources outside clinical trials, and only one study considered costs solely from the trial. CONCLUSION: Despite the increasing emphasis on hypertension as one of the most costly long-term diseases, and the need to reduce costs associated with it, there are relatively few recently published studies on the cost-effectiveness of antihypertensive therapies. Methodologically, these published studies are very different and they do not seem to agree on a common way to provide a cost-effectiveness measure for hypertension treatment, making interpretations and comparability of results across different studies more difficult.