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A pharmacoeconomic evaluation of results from the Coronary Angioplasty Amlodipine Restenosis Study (CAPARES) in Norway and Canada.

https://arctichealth.org/en/permalink/ahliterature53705
Source
Int J Cardiol. 2002 Jul;84(1):23-30; discussion 30-2
Publication Type
Article
Date
Jul-2002
Author
Erik Thaulow
Bjorn Jorgensen
John J Doyle
Roman Casciano
Julian Casciano
Zoe Kopp
Steve Arikian
Renee Kim
Author Affiliation
Department of Cardiology, Rikshospitalet, University of Oslo, Oslo, Norway.
Source
Int J Cardiol. 2002 Jul;84(1):23-30; discussion 30-2
Date
Jul-2002
Language
English
Publication Type
Article
Keywords
Amlodipine - economics - therapeutic use
Angioplasty, Transluminal, Percutaneous Coronary - economics
Calcium Channel Blockers - economics - therapeutic use
Canada
Coronary Artery Bypass - economics
Coronary Restenosis - economics - prevention & control
Cost Control
Decision Trees
Double-Blind Method
Drug Costs
Economics, Pharmaceutical
Humans
Norway
Prospective Studies
Research Support, Non-U.S. Gov't
Treatment Outcome
Abstract
INTRODUCTION: The objective of this analysis was to evaluate the health economic benefits of using amlodipine in patients undergoing angioplasty procedures in Canada and Norway. METHODS: A decision tree model was constructed to find the total expected cost per patient for a 4-month time period following an initial angioplasty. The model used clinical data from the Coronary Angioplasty Amlodipine Restenosis Study (CAPARES), a prospective, randomized, double blind, placebo-controlled trial conducted to investigate the effects of amlodipine on restenosis and clinical events in patients undergoing percutaneous transluminal coronary angioplasty (PTCA). Outcomes of interest to this analysis included MI, repeat PTCA, CABG, and all-cause mortality. Clinical experts from Canada and Norway were enlisted and a modified Delphi study approach was used to quantify healthcare resources consumed for each clinical outcome. RESULTS: The use of amlodipine decreased the rates of MI, PTCA, and CABG by 2.0, 4.7, and 2.7%, respectively. The total expected cost per patient using amlodipine was $6,398.30 (US$4,323) in Canada and kr 59,993.27 (US$6,846) in Norway. The total expected cost per patient not using amlodipine was $6,519.37 (US$4,405) in Canada and kr 64,292.17 (US$7,337) in Norway. The model demonstrated potential cost-savings over a 4-month follow up period resulting from the improved clinical outcomes for patients using amlodipine with PTCA--$121,071 (US$81,844) per 1000 patients in Canada and kr 4,298,899 (US$490,074) per 1000 patients in Norway. CONCLUSIONS: The adjunctive use of amlodipine is a cost-effective therapeutic strategy to achieve more favorable clinical outcomes in patients undergoing PTCAs in Canada and Norway.
PubMed ID
12104059 View in PubMed
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