Pharmacoeconomic evaluation of antihypertensive treatment with fixed combination of Noliprel on economic burden of arterial hypertension

The paper addresses evaluation of economic burden of arterial hypertension in real practice in Russia based on epidemiologic and pharmacoepidemiologic studies and the results of OPTIMAX study. Markov model in 10-year time horizon perspective was used to estimate efficacy of fixed combination of Perindorpil and Indapamide (Noliprel, Servier, France) in hypertensive patients. 3 age female and male groups (under 50, 55 and 60 years old) were formed; direct (personal expenses, expenses of public health budget) and indirect costs (loss of salary, collection of taxes, social expenses) were estimated. Treatment with Noliprel is more effective considering life expectancy and prevention of complications in hypertensive patients as compared to usual treatment AH. Antihypertensive therapy used in real practice demonstrates relatively low direct costs, but high indirect costs; with aging direct costs increase and demands in medical assistance and indirect costs decrease. Noliprel use has cost-saving effect, in particular in men under 50 and 55 years old by decreasing economic burden. Despite the growth of personal expenses (Noliprel cost), public health care budget is saved by the decrease of medical assistance demand in all hypertensive groups (about 2,4-10,4 thousand rubles per patient). Cost of 1 QALY (quality-adjusted life year) shows cost-saving effect of Noliprel treatment in male groups under 50 and 55 years old; in other groups additional expenses are under 2 thousand rubles.

hypertension, economic burden, direct and indirect costs, cost of 1 quality-adjusted life year (QALY), perindopril, Indapamide

1. Global Burden of Disease and Injury Series // The global burden of disease / Ed. By C.J.L. Murray, A.D. Lopez. - Cambridge (MA): Harvard School of Public Health on behalf of the World Health Organization and the World Bank, 1996. Vol. 1. - 475 p.

2.

3. Lawes C.M.M., Hoorn S.V., Law M.R. et al. Blood pressure and global burden of disease 2000. Part II: estimates of attributable burden // J. Hypertens. - 2006. - Vol. 24, № 3. - P. 423-430.

4.

5. Шальнова С.А., Баланова Ю.А., Константинов В.В. и др. Артериальная гипертония: распространенность, осведомленность, прием антигипертензивных препаратов и эффективность лечения среди населения РФ // Рос. кардиол. журн. - 2006. - № 4. - C. 45-50.

6.

7. Sica D.A. Fixed dose combination antihypertensive drugs. Do they have a role in rational therapy // Drugs. - 1994. - Vol. 48, № 1. - P. 16-24.

8.

9. Леонова М.В., Белоусов Д.Ю., Штейнберг Л.Л. и др. Анализ врачебной практики проведения антигипертензивной терапии в России (по данным исследования ПИФАГОР III) // Фарматека. - 2009. - № 12. - C. 54-57.

10.

11. Mourad J.-J., Nguyen V., Lopez-Sublet M., Waeber B. Blood pressure normalization in a large population of hypertensive patients treated with perindopril/indapamide combination: results of the OPTIMAX trial // Vasc. Health Risk Manag. - 2007. - Vol. 3, № 1. - P. 173-180.

12.

13. Conroy R.M., Oganov R.G., Sans S. et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project // Eur. Heart J. - 2003. - Vol. 24, № 11. - P. 987-1003.

14.

15. Куликов А.Ю., Сафиуллин Р.С., Яркаева Ф.Ф. Фармакоэпидемиологическое исследование: Оценка использования лекарственных средств отпускаемых по рецепту врача (фельдшера) при оказании дополнительной бесплатной медицинской помощи отдельным категориям граждан, имеющим право на получение государственной социальной помощи на региональном уровне // Материалы Междунар. конгресса «Развитие фармакоэкономики и фармакоэпидемиологии в РФ». - Москва, 2006.

16.

17. «Сценарные условия функционирования экономики Российской Федерации, основные параметры прогноза социально-экономического развития Российской Федерации на 2009 год и плановый период 2010 и 2011 годов. Москва, Май 2008 г.». - [Электронный ресурс]. URL: <http://www.economy.gov.ru/wps/wcm/myconnect/economylib/mert/welcome/economy/macroeconomy/administmanagementdirect/doc1219319991073>).