Pharmacoeconomic Evaluation of Two Combined Regimens in the Treatment of Hypertension Based on Markov Model

OBJECTIVE To evaluate pharmacoeconomic programme of angiotensin receptor blocker(ARB) combined with dihydropyridine calcium channel blocker(CCB), ARB and thiazide diuretic to treat elderly hypertension by establishing Markov model and to provide evidence for clinical drug use. METHODS Search Medline and PubMed English database, the search terms were “hypertension, calcium channel blockers, diuretics, angiotensin II receptor blocker, randomized controlled trial” and their corresponding MeSH words. Established a Markov model with reference to drug prices, treatment costs, health utility values, and state transition probability, evaluated the effectiveness and economics of the two options, and performed sensitivity analysis. RESULTS The cumulative cost of treatment for hypertension in ARB+CCB group was 32 780.34 yuan, and 6.73 quality-adjusted life years(QALYs). The cumulative cost of treatment for hypertension in ARB+diuretic group was 31 781.07 yuan, which was 6.81 QALYs, compared with the increase of ARB+CCB group, the cost-effective ratio was –12 490.88 yuan/QALYs. Sensitivity analysis was consistent with the original results. CONCLUSION Compared with the ARB+CCB group, the ARB+diuretic group can achieve longer survival results, and the incremental cost‑effect is less than 1 times GDP per capita, which is more economical.