Economic impact of Elantan LA compared to Isordil, Tenormin and Tildiem LA in the treatment of stable angina in the UK

ABSTRACT

This study estimated the NHS cost of treating stable angina with Elantan LA compared to Isordil, Tenormin and Tildiem LA. Angina-related healthcare resource use from the UK Mediplus® database was obtained for new patients, switched patients and existing patients who received one of the four drugs for stable angina and had one of the following Read Codes: history of angina pectoris; history of angina in the last year; angina control; and angina pectoris. Resource use was stratified according to the following comorbidities: ischaemic heart disease (excluding angina); hypertension; congestive cardiac failure; hypercholesterolaemia; and cerebrovascular disease. National resource costs (at 1997/98 prices) were assigned to the resources used, to estimate the cost of each treatment strategy over one year to achieve the same level of clinical effectiveness.

The cost differences between treatments were largely attributable to differences in hospitalisation rates, since primary care resource use was broadly similar across treatments. The acquisition cost of the anti-anginals, hospitalisation and GP visits were the main cost drivers. However, sensitivity analyses showed the results to be robust to realistic changes in the incidence of hospitalisation and the frequency of GP visits.

In conclusion, clinical decisions about choosing between Elantan LA, Isordil, Tenormin and Tildiem LA, which all have similar effectiveness, should not be based on their acquisition cost alone. By accounting for a broader range of healthcare resource use, the nitrates were found to generate economic benefits in all patient groups.

Keywords: :

• Angina
• costs
• economics
• Elantan LA
• Isordil
• nitrates
• Tenormin
• Tildiem LA.