Cost-effectiveness Analysis of Interventions to Improve Control of High Blood Pressure in Low Resource Settings: The Case of Nigeria

2014 ◽  
Vol 2 (2) ◽  
pp. 87-101 ◽  
Author(s):  
Obinna Ekwunife
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
High Blood Pressure ◽  
Cost Effectiveness Analysis ◽  
Low Resource Settings ◽  
Low Resource ◽  
Effectiveness Analysis

scholarly journals Cost Effectiveness Analysis of Candesartan Therapy in Comparison to Candesartan-Amlodipine Therapy on Hypertensive Outpatients

2019 ◽  
Vol 7 (22) ◽  
pp. 3837-3840
Author(s):  
Faridah Baroroh ◽  
Andriana Sari ◽  
Noviana Masruroh
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Significant Difference ◽  
Hypertension Therapy ◽  
The Mean ◽  
The Cost

BACKGROUND: he achievement of optimal hypertension therapy requires cost-effective medicine. The treatment of hypertensive patients needs for long-term medication have made medical costs a prime issue in health economics. AIM: This study aims to determine the cost effectiveness of candesartan therapy compared to candesartan-amlodipine therapy on hypertensive outpatients. METHODS: This is a prospective cohort study that compares candesartan therapy to candesartan-amlodipine therapy at a public hospital from payers’ perspective. The outcome is the percentage of targeted blood pressure decrease after three months of therapy. The cost effectiveness analysis uses the Incremental Cost Effectiveness Ratio (ICER) based on the ratio of cost difference to the outcome in both therapy groups. RESULTS: As many as 111 patients participated in this research, comprising 40 candesartan therapy patients and 71 patients with the combination of candesartan-amlodipine. Of the participants, 63.96% were female, 57.66% were aged 60 or older, and 56.32% had diabetes mellitus as the most common complication. Results show that the average direct medical cost per patient for a therapy of three months with candesartan was IDR 1,050,536 ± 730,007 and IDR 760,040 ± 614,290 for a candesartan-amlodipine therapy. The mean decline of systolic and diastolic blood pressure under candesartan therapy is less than that of candesartan-amlodipine, although without any significant difference (p > 0.05). It follows that the effectiveness of candesartan (85%) is greater than that of the candesartan-amlodipine combination (84.50%). Candesartan therapy is thereby more cost-effective with an ICER value of IDR 580,993/%. CONCLUSION: Hypertension therapy by candesartan is more cost-effective than candesartan-amlodipine therapy with a cost addition of IDR 580,993.

scholarly journals A BAYESIAN APPROACH TO STOCHASTIC COST-EFFECTIVENESS ANALYSIS

2001 ◽  
Vol 17 (1) ◽  
pp. 69-82 ◽  
Author(s):  
Andrew H. Briggs
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Blood Pressure Control ◽  
Bayesian Approach ◽  
Common Ground ◽  
Pressure Control ◽  
Cost Effectiveness Analysis ◽  
Net Benefit ◽  
Effectiveness Analysis ◽  
The Cost

The aim of this paper is to discuss the use of Bayesian methods in cost-effectiveness analysis (CEA) and the common ground between Bayesian and traditional frequentist approaches. A further aim is to explore the use of the net benefit statistic and its advantages over the incremental cost-effectiveness ratio (ICER) statistic. In particular, the use of cost-effectiveness acceptability curves is examined as a device for presenting the implications of uncertainty in a CEA to decision makers. Although it is argued that the interpretation of such curves as the probability that an intervention is cost-effective given the data requires a Bayesian approach, this should generate no misgivings for the frequentist. Furthermore, cost-effectiveness acceptability curves estimated using the net benefit statistic are exactly equivalent to those estimated from an appropriate analysis of ICERs on the cost-effectiveness plane. The principles examined in this paper are illustrated by application to the cost-effectiveness of blood pressure control in the U.K. Prospective Diabetes Study (UKPDS 40). Due to a lack of good-quality prior information on the cost and effectiveness of blood pressure control in diabetes, a Bayesian analysis assuming an uninformative prior is argued to be most appropriate. This generates exactly the same cost-effectiveness results as a standard frequentist analysis.

scholarly journals Cost Effectiveness Analysis Therapy Combination of Candesartan-Amlodipine and Candesartan-Diltiazem on Hypertensive Outpatients

2018 ◽  
Vol 14 (2) ◽  
pp. 188
Author(s):  
Faridah Baroroh ◽  
Andriana Sari
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Blood Pressure Reduction ◽  
Cost Effectiveness Analysis ◽  
Pressure Reduction ◽  
Research Subjects ◽  
Cost Effectiveness Ratio ◽  
Cost Component ◽  
Effectiveness Analysis ◽  
The Cost

Hypertension medication is taken for a long period and thus requires considerable costs. As antihypertensives vary in efficacy, research is needed to assess the cost effectiveness of medication, particularly between candesartan-amlodipine and candesartan-diltiazem combinations on hypertensive outpatients. This study applied a prospective cohort design with outcome observations for three months at a private hospital in Yogyakarta. The outcome used to gauge the cost effectiveness of medication was the achievement of the targeted blood pressure reduction after treatment. The cost effectiveness analysis was conducted through payer’s perspective, namely that of the social security agency (BPJS), with direct medical cost as the cost component measured. Cost effectiveness was analyzed using an average cost effectiveness ratio (ACER), calculated according to the ratio of cost to the outcome percentage of the blood pressure reduction target attainment, and an incremental cost effectiveness ratio (ICER) based on the ratio between differences in cost and outcome in both medication groups. The research subjects consisted of 33 patients, 24 of whom underwent medication with candesartan-amlodipine combination and 9 with candesartan-diltiazem. As many as 81.82% were female and 72.73% were within the age range of 51-70, while their most frequent complication was diabetes mellitus (48.48%). Results revealed the effectiveness of candesartan-amlodipine medication to be 58.33% with an ACER value of IDR 6,617, whereas that of candesartan-diltiazem was 22.22% with an ACER of IDR 29,733. The ICER value was IDR -7607, indicating that candesartan-amlodipine was categorically more cost-effective than candesartan-diltiazem.

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