TY - JOUR
T1 - Pharmacoeconomic evaluation of hypothetical over-the-counter angiotensin-converting enzyme (ACE) inhibitors for the prevention of stroke in patients with grade I hypertension
AU - Uchikura, Takeshi
AU - Yokoi, Nobuyuki
AU - Hashiguchi, Masayuki
AU - Mochizuki, Mayumi
N1 - Copyright:
Copyright 2011 Elsevier B.V., All rights reserved.
PY - 2011
Y1 - 2011
N2 - The effectiveness and safety of angiotensin-converting enzyme (ACE) inhibitors for the treatment of hypertension have been confirmed during long-term use. Therefore, ACE inhibitors were selected as one candidate for the switch from ethical drugs to over-the-counter (OTC) medications. The objective of this study was to perform a cost-effectiveness analysis if ACE inhibitors were switched to OTC medications and used by grade I hypertension patients in Japan. We conducted a cost-effectiveness analysis from a social perspective over a lifetime horizon using a Markov Model in 50- year-old men and women with grade I hypertension. They were divided into 3 groups: 1) untreated group; 2) consultation group visiting a clinic and receiving prescriptions for ACE inhibitors; and 3) OTC group purchasing OTC ACE inhibitors. The cost of OTC medications was estimated based on a previous study of willingness to pay (¥7,237/month). Average life expectancies in both the OTC and consultation groups were 20.20 for men and 22.63 for women, while in the untreated group it was 19.97 for men and 22.47 for women. Incremental costs per expected life-year (ICER) were ¥1,743,557 for men and ¥8,647,069 for women in the OTC group and ¥3,819,861 for men and ¥9,639,844 for women in the consultation group. These results suggest that longer life expectancies can be achieved with ACE inhibitors, and the total cost is decreased using OTC ACE inhibitors compared with ethical drugs. OTC ACE inhibitors therefore appear be a useful alternative for patients who do not have time to visit a clinic regularly.
AB - The effectiveness and safety of angiotensin-converting enzyme (ACE) inhibitors for the treatment of hypertension have been confirmed during long-term use. Therefore, ACE inhibitors were selected as one candidate for the switch from ethical drugs to over-the-counter (OTC) medications. The objective of this study was to perform a cost-effectiveness analysis if ACE inhibitors were switched to OTC medications and used by grade I hypertension patients in Japan. We conducted a cost-effectiveness analysis from a social perspective over a lifetime horizon using a Markov Model in 50- year-old men and women with grade I hypertension. They were divided into 3 groups: 1) untreated group; 2) consultation group visiting a clinic and receiving prescriptions for ACE inhibitors; and 3) OTC group purchasing OTC ACE inhibitors. The cost of OTC medications was estimated based on a previous study of willingness to pay (¥7,237/month). Average life expectancies in both the OTC and consultation groups were 20.20 for men and 22.63 for women, while in the untreated group it was 19.97 for men and 22.47 for women. Incremental costs per expected life-year (ICER) were ¥1,743,557 for men and ¥8,647,069 for women in the OTC group and ¥3,819,861 for men and ¥9,639,844 for women in the consultation group. These results suggest that longer life expectancies can be achieved with ACE inhibitors, and the total cost is decreased using OTC ACE inhibitors compared with ethical drugs. OTC ACE inhibitors therefore appear be a useful alternative for patients who do not have time to visit a clinic regularly.
KW - Angiotensin-converting enzyme (ACE) inhibitor
KW - Cost-effectiveness
KW - Hypertension
KW - Over-the-counter (OTC) medication
KW - Pharmacoeconomics
KW - Stroke
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U2 - 10.1248/yakushi.131.571
DO - 10.1248/yakushi.131.571
M3 - Article
C2 - 21467797
AN - SCOPUS:79953685220
VL - 131
SP - 571
EP - 580
JO - Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan
JF - Yakugaku zasshi : Journal of the Pharmaceutical Society of Japan
SN - 0031-6903
IS - 4
ER -