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An Economic Evaluation of Irbesartan in the Treatment of Patients with Type 2 Diabetes, Hypertension and Nephropathy: Cost-Effectiveness of Irbesartan in Diabetic Nephropathy Trial (IDNT) in the Belgian and French Settings

Citation

Palmer, AJ and Annemans, L and Roze, S and Lamotte, M and Rodby, RA and Cordonnier, DJ, An Economic Evaluation of Irbesartan in the Treatment of Patients with Type 2 Diabetes, Hypertension and Nephropathy: Cost-Effectiveness of Irbesartan in Diabetic Nephropathy Trial (IDNT) in the Belgian and French Settings, Nephrology, Dialysis and Transplantation, 18, (10) pp. 2059-2066. ISSN 0931-0509 (2003) [Refereed Article]

DOI: doi:10.1093/ndt/gfg232

Abstract

Background. In the Irbesartan in Diabetic Nephropathy Trial (IDNT), treatment with irbesartan demonstrated 23 and 20% reductions in the combined endpoint of doubling of serum creatinine (DSC), end-stage renal disease (ESRD) or death in patients with hypertension, type 2 diabetes and overt nephropathy compared with amlodipine and control, respectively. A simulation model was developed to project long-term cost consequences of the IDNT in Belgium and France. Methods. A Markov model simulated progression from nephropathy to DSC, ESRD and death in patients with hypertension, type 2 diabetes and overt nephropathy. Treatment-specific probabilities were derived from IDNT. Country-specific ESRD-related data were retrieved from published sources. Delay in onset of ESRD, life expectancy and mean lifetime costs were calculated for patients with a baseline age of 59 years. Future costs were discounted at 3% per annum (p.a.), and clinical benefits were discounted at 0 and 3% p.a.. Extensive sensitivity analyses were performed. Results. Onset of ESRD was delayed with irbesartan by 1.41 and 1.35 years vs amlodipine and control, respectively. When a 10-year time horizon was considered, delay in ESRD onset led to anticipated improvements in life expectancy of 0.13 years vs amlodipine and 0.26 years vs control. Irbesartan was associated with cost savings of E14949 and E9205/patient in Belgium, and E20128 and E13337 in France, vs amlodipine and control, respectively. The results were robust under a wide range of plausible assumptions. Conclusions. Treating patients with hypertension, type 2 diabetes and overt nephropathy using irbesartan was both cost- and life-saving compared with amlodipine and control.

Item Details

Item Type:Refereed Article
Research Division:Economics
Research Group:Applied Economics
Research Field:Health Economics
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Health Policy Economic Outcomes
Author:Palmer, AJ (Professor Andrew Palmer)
ID Code:74720
Year Published:2003
Web of Science® Times Cited:34
Deposited By:Research Division
Deposited On:2011-12-12
Last Modified:2011-12-13
Downloads:0

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