The Economic Evaluation of Three Kinds of Angiotensin �� Receptor Blockers in Stroke and Myocardial Infarction Prevention among Hypertension Patients Using Markov Model
LIU Li-qin1, LI Qing2*, HU Ming3, LI Mei-juan1, YANG Han3
1. School of Pharmacy, Shanxi Medical University, Taiyuan 030001, China; 2. Department of Pharmacy, The First Affiliated Hospital of Shanxi Medical University, Taiyuan 030001, China; 3. School of Pharmacy, Sichuan Huaxi University, Chengdu 610000, China
Abstract��OBJECTIVE To investigate the long-term economic consequences of candesartan cilexetil��irbesartan and telmisartan in preventing stroke and myocardial infarction (MI) among hypertension patients using Markov model, to offer the reference for hypertension intervention. METHODS A Markov state transition model was built based on the natural history of hypertension from the societal perspective to estimate the expected health care costs and the quality adjusted life years. Meanwhile, the incremental cost-effectiveness ratio was obtained. One year cycle length and 20 years horizon were adopted. The 5% yearly discount rate was applied to both health care costs and QALYs. One-way sensitivity analysis, second-order Monte-Carlo and probabilistic sensitivity analysis were performed. RESULTS Candesartan cilexetil was at an absolute disadvantage because of the highest cost and the lowest effect in the baseline analysis. The incremental cost-effectiveness ratio for irbesartan versus telmisartan was 5 799.67 yuan/QALY. The sensitivity analysis was consistent with the baseline results. CONCLUSION Irbesartan shows significant economic advantage at the threshold of 49 992 yuan/QALY compared with telmisartan. And candesartan cilexetil is with less economical.
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LIU Li-qin, LI Qing, HU Ming, LI Mei-juan, YANG Han. The Economic Evaluation of Three Kinds of Angiotensin �� Receptor Blockers in Stroke and Myocardial Infarction Prevention among Hypertension Patients Using Markov Model. Chinese Pharmaceutical Journal, 2019, 54(2): 137-143.
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2019, Vol. 54 
