OBJECTIVE:Hypertension is a major issue in public health, and the financial costs associated with hypertension continue to increase. Cost-effectiveness studies focusing on antihypertensive drug combinations, however, have been scarce. The cost-effectiveness ratios of the traditional treatment (hydrochlorothiazide and atenolol) and the current treatment (losartan and amlodipine) were evaluated in patients with grade 1 or 2 hypertension (HT1-2). For patients with grade 3 hypertension (HT3), a third drug was added to the treatment combinations: enalapril was added to the traditional treatment, and hydrochlorothiazide was added to the current treatment.METHODS:Hypertension treatment costs were estimated on the basis of the purchase prices of the antihypertensive medications, and effectiveness was measured as the reduction in systolic blood pressure and diastolic blood pressure (in mm Hg) at the end of a 12-month study period.RESULTS:When the purchase price of the brand-name medication was used to calculate the cost, the traditional treatment presented a lower cost-effectiveness ratio [US$/mm Hg] than the current treatment in the HT1-2 group. In the HT3 group, however, there was no difference in cost-effectiveness ratio between the traditional treatment and the current treatment. The cost-effectiveness ratio differences between the treatment regimens maintained the same pattern when the purchase price of the lower-cost medication was used.CONCLUSIONS:We conclude that the traditional treatment is more cost-effective (US$/mm Hg) than the current treatment in the HT1-2 group. There was no difference in cost-effectiveness between the traditional treatment and the current treatment for the HT3 group.
ObjectiveTo assess whether the treatment with levosimendan is more expensive than the usual one with dobutamine, since price of medications does not usually represent the greatest expense in the treatment of cardiac decompensation. MethodsThe cost of treatment of 18 inpatients with cardiac decompensation, 9 of which treated with dobutamine (dobuta group) and 9 with levosimendan (levo group), was compared. Groups were similar concerning age, sex, functional class and cardiac function. ResultsTreatment costs were similar for both groups. In the levo group, the costs with the drug were higher than in the dobuta group, but those related to the length of stay in intensive care unit and to the material used during admission were lower. Levo -drug: R$ 5,414.00; material: R$ 399.90; hospital daily rates: R$ 5,061.20; professional honorarium: R$ 3,241.80; total costs: R$ 14,117.00. Dobuta -drug: R$ 2,320.10; materials: R$ 1,665.70; hospital daily rates: R$ 6,261.90; professional honorarium: R$ 3,894.30; total costs: R$ 14,142.00. ConclusionDespite the higher price of levosimendan, the global cost of the treatment was similar for patients who were treated either with dobutamine or levosimendan. Patients who were treated with levosimendan had a shorter length of stay in intensive care unit.
Tsuji RLG. Economic evaluation of the diagnostic strategies and treatment of blood pressure: CBPM, HBPM and ABPM [thesis].
pela sua característica peculiar de ter aceitado este desafio e tratá-lo com seriedade e orientação segura.Ao Dr Wilson Follador por me despertar o interesse da farmacoeconomia.Ao Prof. Dr. Antonio Carlos Zanini pela oportunidade da pesquisa inicial.A Julia Tizue Fukushima pela perspicácia na condução da análise estatística.A Dra Kátia Ortega e ao Dr Giovânio Vieira da Silva pela colaboração de valor incomparável.As secretárias Maria Elisa, Aline e Eliane sempre prestativas.Ao Dr Rui Toledo, coordenador de pós graduação, pelo incentivo na condução da pesquisa.Aos professores da Disciplina de Nefrologia pela oportunidade de desenvolver esta dissertação.Ao engenheiro João Marcos pelo auxílio na elaboração das equações matemáticas.Aos colegas da pós graduação Giovânio, Josiane, Ana Lúcia, Kátia, Silvana e Tatiana pelas importantes sugestões.A amiga Elizabeth Fefferman Darin pelo apoio e compartilhamento nos momentos mais difíceis.A Dra Selma Tsuji e ao Dr Dalton Bertolini pela leitura e precisas opiniões.O único homem que nunca comete erros é aquele que nunca faz coisa alguma. Não tenha medo de errar, pois você aprenderá a não cometer duas vezes o mesmo erro.
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