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An economic evaluation of the Irbesartan in Diabetic Nephropathy Trial (IDNT) in a UK setting

journal contribution
posted on 2023-05-17, 09:29 authored by Andrew PalmerAndrew Palmer, Annemans, L, Roze, S, Lamotte, M, Rodby, RA, Bilous, RW
There are substantial healthcare costs associated with the provision of renal replacement therapy. Patients with diabetes mellitus are the largest and fastest growing group developing end-stage renal disease (ESRD) in the United Kingdom (UK). Treatment leading to a slowing of progression to ESRD in diabetic patients could lead to considerable cost savings. Using treatment-specific probabilities derived from the Irbesartan in Diabetic Nephropathy Trial (IDNT), the cost effectiveness of treating patients with hypertension, type II diabetes and nephropathy with irbesartan, amlodipine or control was calculated using a Markov model. UK-specific ESRD-related data were retrieved from published sources to reflect local management practices, ESRD outcomes and costs. Mean 10-year costs and changes in life expectancy due to ESRD delayed or avoided were calculated. Future costs and clinical benefits were discounted at 6.0 and 1.5% per annum and extensive sensitivity analyses were performed. Delay in the onset of ESRD with irbesartan led to cost savings of £5125 and £2919/patient and improvements in projected discounted life expectancy of 0.07 and 0.21 years over 10 years vs amlodipine and control, respectively. The costs of treatment of ESRD were the main contributor to the total costs. The cost of trial medications had only a minor impact. These results were robust in a wide range of plausible assumptions. Given that the IDNT efficacy results could be translated to a UK setting, treating patients with hypertension, type II diabetes and overt nephropathy with irbesartan was cost saving over a 10-year period compared to amlodipine and control. © 2004 Nature Publishing Group All rights reserved.

History

Publication title

Journal of Human Hypertension

Volume

18

Issue

10

Pagination

733-738

ISSN

0950-9240

Department/School

Menzies Institute for Medical Research

Publisher

Nature Publishing Group

Place of publication

Macmillan Building, 4 Crinan St, London, England, N1 9Xw

Repository Status

  • Restricted

Socio-economic Objectives

Evaluation of health and support services not elsewhere classified

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