Abstract
The irbesartan in Diabetic Nephropathy Trial (IDNT) demonstrated that treatment of patients with type 2 diabetes, hypertension and nephropathy with irbesartan resulted in a 20% relative reduction of the composite endpoint of doubling serum creatinine, end-stage renal disease or death as compared with amlodipine and placebo (antihypertensive standard therapy). The objective of this study was to investigate the long-term health economic consequences of this treatment strategy in a Swiss health care setting. This analysis used a Markov model to simulate the progression of nephropathy, life-years and treatment costs over ten years for each of the three treatment options. In additon, sensitivity analyses were performed. Treatment with irbesartan will save CHF 22681/patient as compared with amlodipine and CHF 13847 as compared with standard therapy.
MeSH terms
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Amlodipine / economics
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Amlodipine / therapeutic use
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Angiotensin II Type 1 Receptor Blockers / administration & dosage
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Angiotensin II Type 1 Receptor Blockers / economics*
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Angiotensin II Type 1 Receptor Blockers / therapeutic use*
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Antihypertensive Agents / administration & dosage
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Antihypertensive Agents / economics*
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Antihypertensive Agents / therapeutic use*
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Biphenyl Compounds / administration & dosage
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Biphenyl Compounds / economics*
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Biphenyl Compounds / therapeutic use*
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Calcium Channel Blockers / economics
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Calcium Channel Blockers / therapeutic use
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Cohort Studies
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Cost Savings
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Costs and Cost Analysis
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Diabetes Mellitus, Type 2 / complications
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Diabetes Mellitus, Type 2 / drug therapy*
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Diabetes Mellitus, Type 2 / economics*
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Diabetic Nephropathies / drug therapy*
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Diabetic Nephropathies / economics*
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Diabetic Nephropathies / mortality
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Diabetic Nephropathies / surgery
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Disease Progression
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Follow-Up Studies
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Humans
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Hypertension / drug therapy*
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Hypertension / economics*
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Hypertension / etiology
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Irbesartan
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Kidney Failure, Chronic / etiology
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Kidney Transplantation / economics
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Markov Chains
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Multicenter Studies as Topic
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Placebos
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Randomized Controlled Trials as Topic
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Renal Dialysis
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Risk
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Sensitivity and Specificity
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Switzerland
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Tetrazoles / administration & dosage
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Tetrazoles / economics*
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Tetrazoles / therapeutic use*
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Time Factors
Substances
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Angiotensin II Type 1 Receptor Blockers
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Antihypertensive Agents
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Biphenyl Compounds
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Calcium Channel Blockers
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Placebos
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Tetrazoles
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Amlodipine
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Irbesartan