Economic evaluation of ramipril in the treatment of patients at high risk for cardiovascular events

SUMMARY

Cardiovascular disease (CVD) is a primary cause of death and morbidity in the United Kingdom (UK). Recently, the Heart Outcomes Prevention Evaluation (HOPE) trial demonstrated significant survival and morbidity benefits associated with ramipril use in the treatment of patients at high risk for cardiovascular events. The purpose of this paper is to assess whether and to what extent, these clinical benefits might translate into economic benefits from the perspective of the UK NHS. Using trial data and a decision-analytic model, our base case estimate of cost-effectiveness is £4,406 per life-year saved (undiscounted) and £5,544 per life-year saved (discounted). The extreme values of our sensitivity analyses ranged from a best case of £2,814 per life-year saved (undiscounted) to a worst case of £10,291 per life-year saved (undiscounted). Our base case estimate of cost-effectiveness suggests that treating patients at high risk for CVD events with ramipril is likely to be a good investment of NHS resources.

Keywords: :

• Cost-effectiveness
• hypertension
• HOPE trial
• economic analysis