English, Article edition: Cost Effectiveness of Ramipril in Patients at High Risk for Cardiovascular Events: Economic Evaluation of the HOPE (Heart Outcomes Prevention Evaluation) Study for Germany from the Statutory Health Insurance Perspective Peter K. Schadlich; Josef G. Brecht; Badrudin Rangoonwala; ...

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Physical Description
  • article
Language
  • English

Edition details

Title
  • Cost Effectiveness of Ramipril in Patients at High Risk for Cardiovascular Events: Economic Evaluation of the HOPE (Heart Outcomes Prevention Evaluation) Study for Germany from the Statutory Health Insurance Perspective
Author
  • Peter K. Schadlich
  • Josef G. Brecht
  • Badrudin Rangoonwala
  • Eduard Huppertz
Physical Description
  • article
Notes
  • Background: In the HOPE (Heart Outcomes Prevention Evaluation) trial, ramipril (compared with placebo) significantly reduced cardiovascular death and all-cause mortality as well as the incidence of costly cardiovascular events, such as myocardial infarction, revascularisation, stroke, cardiac arrest, hospitalisation due to heart failure and worsening angina pectoris, new-onset diabetes mellitus and microvascular diabetic complications. Objective: Data from the HOPE study were used in a cost-effectiveness analysis to determine the additional cost per life-year gained (LYG) when the ACE inhibitor ramipril was added to the current medication of patients at high risk for cardiovascular events. The aim was to establish the incremental cost-effectiveness ratio (ICER) of ramipril versus placebo from the perspective of the Statutory Health Insurance (SHI) provider in Germany, for both the study population as a whole and for the subgroup of patients with diabetes. Design: A modelling approach was used, based on secondary analysis of published data and retrospective application of costs. In the base-case analysis, average case-related expenses of the SHI were applied and LYG were quantified using the average of the difference between the survival rates in the ramipril and placebo groups during the HOPE trial. LYG beyond the trial duration were estimated by the method of declining exponential approximation of life expectancy. Results: After a treatment period of 4.5 years, the ICER of ramipril versus placebo was Conclusions: Results of this evaluation suggest that ramipril is likely to be cost effective in secondary prevention of cardiovascular events from the perspective of the SHI (third-party payer) in Germany. The estimated ICER of ramipril compares well with other ICERs of widely accepted treatments used for the management of cardiovascular diseases, such as HMG-CoA reductase inhibitors.
  • ACE-inhibitors, Cardiovascular-disorders, Cardiovascular-disorders, Cost-effectiveness, Ramipril
  • RePEc:wkh:phecon:v:22:y:2004:i:15:p:955-973
Language
  • English
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