Skip to main content
Top
Published in: PharmacoEconomics 4/2006

01-04-2006 | Original Research Article

A Cost-Utility Analysis of Losartan versus Atenolol in the Treatment of Hypertension with Left Ventricular Hypertrophy

Authors: Dr Aslam H. Anis, Huiying Sun, Sonia Singh, John Woolcott, Bohdan Nosyk, Marc Brisson

Published in: PharmacoEconomics | Issue 4/2006

Login to get access

Abstract

Introduction: The LIFE (Losartan Intervention For Endpoint reduction in hypertension) study demonstrated a 13% relative risk reduction in the primary composite endpoint (myocardial infarction, stroke or death) for patients with hypertension and electrocardiographically diagnosed left ventricular hypertrophy (LVH) treated with losartan compared with atenolol. Losartan recipients also had a 25% relative risk reduction for stroke compared with atenolol recipients. Incorporating the results found in the LIFE study into an economic model, an incremental cost-effectiveness analysis was performed comparing losartan with atenolol in the treatment of 67-year old patients with hypertension and LVH.
Methods: A Markov state transition model, based on published results of the LIFE trial (mean follow-up of 4.8 years), was utilised to extrapolate the outcomes observed in this trial to the patients’ lifetime. Utility estimates for the associated health states were obtained from various published sources. Lifetime treatment costs were calculated adopting a societal perspective. Both costs and benefits were discounted and incremental cost-effectiveness ratios (ICERs) were estimated. One-way and probabilistic sensitivity analyses were performed.
Results: The estimated ICER for losartan versus atenolol was $Can1337 per QALY gained ($Can1 = $US0.75, 2002 values). This ICER was robust to extensive sensitivity analysis, demonstrating a 95% probability that the ICER would be <$Can20 000 per QALY gained.
Conclusion: From a Canadian societal perspective, losartan appears to be a cost-effective alternative to atenolol in patients with hypertension and LVH. The estimated ICERs, including the sensitivity analyses, were within the range of cost-effectiveness ratios for various currently funded interventions and drugs in developed countries.
Appendix
Available only for authorised users
Literature
1.
go back to reference Murray CJLM, Lopez AD. Evidence-based health policy-lessons from the global burden of disease study. Science 1996; 274: 740–743PubMedCrossRef Murray CJLM, Lopez AD. Evidence-based health policy-lessons from the global burden of disease study. Science 1996; 274: 740–743PubMedCrossRef
2.
go back to reference Joffres MR, Ghadirian P, Fodor JG, et al. Awareness, treatment and control of hypertension in Canada. Am J Hypertens 1997; 10 (10 Pt 1): 1097–1102PubMedCrossRef Joffres MR, Ghadirian P, Fodor JG, et al. Awareness, treatment and control of hypertension in Canada. Am J Hypertens 1997; 10 (10 Pt 1): 1097–1102PubMedCrossRef
3.
go back to reference Hansson L, Lindholm LH, Ekbom T, et al. Randomised trial of old and new anti-hypertensive drugs in elderly patients: cardiovascular mortality and morbidity, the Swedish trial in old patients with Hypertension-2 study. Lancet 1999; 354: 1751–1756PubMedCrossRef Hansson L, Lindholm LH, Ekbom T, et al. Randomised trial of old and new anti-hypertensive drugs in elderly patients: cardiovascular mortality and morbidity, the Swedish trial in old patients with Hypertension-2 study. Lancet 1999; 354: 1751–1756PubMedCrossRef
4.
go back to reference Neal B, MacMahon S, Chapman N. Fifects of ACE inhibitors, calcium antagonist, and other blood-pressure-Iowering drugs: results of prospectively designed overviews of randomized trials. Blood Pressure Lowering Treatment Trialists’ Collaboration. Lancet 2000; 356: 1955–1964PubMedCrossRef Neal B, MacMahon S, Chapman N. Fifects of ACE inhibitors, calcium antagonist, and other blood-pressure-Iowering drugs: results of prospectively designed overviews of randomized trials. Blood Pressure Lowering Treatment Trialists’ Collaboration. Lancet 2000; 356: 1955–1964PubMedCrossRef
5.
go back to reference Yusuf S, Sleight P, Pogue J, et al. Fifects of an angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients: the Heart Outcomes Prevention Evaluation Study investigators. N Engl J Med 2000; 342: 145–153PubMedCrossRef Yusuf S, Sleight P, Pogue J, et al. Fifects of an angiotensin-converting enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients: the Heart Outcomes Prevention Evaluation Study investigators. N Engl J Med 2000; 342: 145–153PubMedCrossRef
6.
go back to reference Davis BR, Cutler JA, Gordon DJ, et al. Rationale and design for the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). ALLHAT Research Group. Am J Hypertens 1996; 9: 342–360PubMedCrossRef Davis BR, Cutler JA, Gordon DJ, et al. Rationale and design for the Antihypertensive and Lipid Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). ALLHAT Research Group. Am J Hypertens 1996; 9: 342–360PubMedCrossRef
7.
go back to reference Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention for End point reduction in hypertension study (UFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003PubMedCrossRef Dahlof B, Devereux RB, Kjeldsen SE, et al. Cardiovascular morbidity and mortality in the Losartan Intervention for End point reduction in hypertension study (UFE): a randomised trial against atenolol. Lancet 2002; 359: 995–1003PubMedCrossRef
8.
go back to reference Rundek T, Mast H, Hartmann A, et al. Predictors of resource use after acute hospitalization the northern Manhattan stroke study. Neurology 2000; 55: 1180–1187PubMedCrossRef Rundek T, Mast H, Hartmann A, et al. Predictors of resource use after acute hospitalization the northern Manhattan stroke study. Neurology 2000; 55: 1180–1187PubMedCrossRef
9.
go back to reference Tengs JO, Lin TH. A meta-analysis of quality-of-life estimates for stroke. Pharmacoeconomics 2003; 21 (3): 191–200PubMedCrossRef Tengs JO, Lin TH. A meta-analysis of quality-of-life estimates for stroke. Pharmacoeconomics 2003; 21 (3): 191–200PubMedCrossRef
10.
go back to reference Sinclair SE, Frighetto L, Loewen PS, et al. Cost utility analysis of tissue plasminogen activator therapy for acute ischaemic stroke: a Canadian healthcare perspective. Pharmacoeconomics 2001; 19 (9): 927–936PubMedCrossRef Sinclair SE, Frighetto L, Loewen PS, et al. Cost utility analysis of tissue plasminogen activator therapy for acute ischaemic stroke: a Canadian healthcare perspective. Pharmacoeconomics 2001; 19 (9): 927–936PubMedCrossRef
11.
go back to reference Stein JD, Brown GC, Brown MM, et al. The quality of life of patients with hypertension. J Clin Hypertens 2002 May–Jun; 4 (3), 181–188CrossRef Stein JD, Brown GC, Brown MM, et al. The quality of life of patients with hypertension. J Clin Hypertens 2002 May–Jun; 4 (3), 181–188CrossRef
12.
go back to reference Gore JM, Granger CB, Maarten SL, et al. Stroke afterthrorrbolysis: mortality and functional outcomes in the GUSTO-I trial. Circulation 1995; 92: 2811–2818PubMedCrossRef Gore JM, Granger CB, Maarten SL, et al. Stroke afterthrorrbolysis: mortality and functional outcomes in the GUSTO-I trial. Circulation 1995; 92: 2811–2818PubMedCrossRef
13.
go back to reference Kolominsky-Rabas PL, Sarti C, Heuschmann PU, et al. A prospective community-based study of stroke in Germany: the Eclangen Stroke Project. Stroke 1998; 29 (12): 2501–2506PubMedCrossRef Kolominsky-Rabas PL, Sarti C, Heuschmann PU, et al. A prospective community-based study of stroke in Germany: the Eclangen Stroke Project. Stroke 1998; 29 (12): 2501–2506PubMedCrossRef
14.
go back to reference Tu N, Austin PC, Walld R, et al. Development and validation of the Ontario acute myocardial infarction mortality prediction rules. J Am Coll Cardiol 2001; 37 (4): 992–997PubMedCrossRef Tu N, Austin PC, Walld R, et al. Development and validation of the Ontario acute myocardial infarction mortality prediction rules. J Am Coll Cardiol 2001; 37 (4): 992–997PubMedCrossRef
15.
go back to reference Statistics Canada. Life table [online]. Available from URL: http://www.statcan.ca/english/freepub/84-537-XIE/free.htm [Accessed 2003 Nov] Statistics Canada. Life table [online]. Available from URL: http://​www.​statcan.​ca/​english/​freepub/​84-537-XIE/​free.​htm [Accessed 2003 Nov]
16.
go back to reference Government of British Columbia. Pharmacare low cost alternative reference drug program booklet. Version 1.1. 2003 Jan 15 [online]. Available from URL: http://www.healthservices.gov.bc.ca/pharme/outgoing/lca-rdpbooklet2004-11-24.pdf [Accessed 2003 Nov] Government of British Columbia. Pharmacare low cost alternative reference drug program booklet. Version 1.1. 2003 Jan 15 [online]. Available from URL: http://​www.​healthservices.​gov.​bc.​ca/​pharme/​outgoing/​lca-rdpbooklet2004-11-24.​pdf [Accessed 2003 Nov]
17.
go back to reference British Columbia Ministry of Health Services. Pharmacare Newsletter. January 23, 2002 [online]. Available from URL: http://www.healthservices.gov.bc.ca/pharme/newsletter/02001news.pdf [Accessed 2003 Nov] British Columbia Ministry of Health Services. Pharmacare Newsletter. January 23, 2002 [online]. Available from URL: http://​www.​healthservices.​gov.​bc.​ca/​pharme/​newsletter/​02001news.​pdf [Accessed 2003 Nov]
18.
go back to reference British Columbia Ministry of Health Service. Pharmacare maximum days’ supply policy [online]. Available from URL: http://www.hlth.gov.bc.ca/pharme/generalinfo/maxdays.html [Accessed 2003 Nov] British Columbia Ministry of Health Service. Pharmacare maximum days’ supply policy [online]. Available from URL: http://​www.​hlth.​gov.​bc.​ca/​pharme/​generalinfo/​maxdays.​html [Accessed 2003 Nov]
19.
go back to reference Management Information Systems Project Steering Committee. Guidelines for management information systems in Canadian healthcare facilities. Ottawa (ON): The MIS Group, 2002 Management Information Systems Project Steering Committee. Guidelines for management information systems in Canadian healthcare facilities. Ottawa (ON): The MIS Group, 2002
20.
go back to reference British Columbia Medical Association. BCMA guide to fees. 2002 [online]. Available from URL: http://www.bcma.org/public/news_publications/publications/fee_guide.htm [Accessed 2003 Nov] British Columbia Medical Association. BCMA guide to fees. 2002 [online]. Available from URL: http://​www.​bcma.​org/​public/​news_​publications/​publications/​fee_​guide.​htm [Accessed 2003 Nov]
21.
go back to reference Canadian Institute for Health Information [online]. Available from URL: http://secure.cihi.ca/cihiweb/dispPagejsp?cw_page=statistics_topic_e [Accessed 2003 Nov] Canadian Institute for Health Information [online]. Available from URL: http://​secure.​cihi.​ca/​cihiweb/​dispPagejsp?​cw_​page=​statistics_​topic_​e [Accessed 2003 Nov]
22.
go back to reference Tung CY, Granger CB, Sloan MA, et al. Effects of stroke on medical resource and costs in acute myocardial infarction. Circulation 1999 Jan 26; 99 (3): 370–376PubMedCrossRef Tung CY, Granger CB, Sloan MA, et al. Effects of stroke on medical resource and costs in acute myocardial infarction. Circulation 1999 Jan 26; 99 (3): 370–376PubMedCrossRef
23.
go back to reference Canadian Institute for Health Information [online]. Available from http://secure.cihi.ca/cihiweb/dispPage.jsp?cw_page=statistics_topic_e [Accessed 2003 Nov] Canadian Institute for Health Information [online]. Available from http://​secure.​cihi.​ca/​cihiweb/​dispPage.​jsp?​cw_​page=​statistics_​topic_​e [Accessed 2003 Nov]
24.
go back to reference Adams HP, Adams RJ, Brott T, et al. Guidelines for the early management of patients with ischemic stroke: a scientific statement from the Stroke Council of the American Stroke Association. Stroke 2003; 42: 1056–1083CrossRef Adams HP, Adams RJ, Brott T, et al. Guidelines for the early management of patients with ischemic stroke: a scientific statement from the Stroke Council of the American Stroke Association. Stroke 2003; 42: 1056–1083CrossRef
25.
go back to reference Hollander MJ. Unfinished business: the case for chronic home care services, a policy paper. Victoria (BC): Hollander Analytical Services Ltd, 2003 Aug Hollander MJ. Unfinished business: the case for chronic home care services, a policy paper. Victoria (BC): Hollander Analytical Services Ltd, 2003 Aug
26.
go back to reference Dickstein K, Kjekshus J. Comparison of baseline data, initial course and management: losartan vs captopril following acute myocardial infarction. Am J Cardiol 2001; 87: 766–771PubMedCrossRef Dickstein K, Kjekshus J. Comparison of baseline data, initial course and management: losartan vs captopril following acute myocardial infarction. Am J Cardiol 2001; 87: 766–771PubMedCrossRef
27.
go back to reference Hart RG, Halpern JL. Atrial fibrillation and stroke: concepts and controversies. Stroke 2001; 32: 803–808PubMedCrossRef Hart RG, Halpern JL. Atrial fibrillation and stroke: concepts and controversies. Stroke 2001; 32: 803–808PubMedCrossRef
28.
go back to reference Drummond MF, O’Brien BJ, Stoddart GL, et al. Methods for the economic evaluation of health care programmes. 2nd ed. Toronto: University Oxford Press, 1997: 164 Drummond MF, O’Brien BJ, Stoddart GL, et al. Methods for the economic evaluation of health care programmes. 2nd ed. Toronto: University Oxford Press, 1997: 164
29.
go back to reference O’Brien B. Economic evaluation of pharmaceuticals: Frankenstein’s monster or vampire of trials? Med Care 1996; 34 (12 Suppl.): DS99–DS108PubMed O’Brien B. Economic evaluation of pharmaceuticals: Frankenstein’s monster or vampire of trials? Med Care 1996; 34 (12 Suppl.): DS99–DS108PubMed
30.
go back to reference Product monograph. Cozaar® losartan potassium tablets. Whitehouse Station (NJ): Merck & Co Inc [online]. Available from URL: http://www.merckfrosst.com/e/cozaar/home.html [Accessed 2003 Nov] Product monograph. Cozaar® losartan potassium tablets. Whitehouse Station (NJ): Merck & Co Inc [online]. Available from URL: http://​www.​merckfrosst.​com/​e/​cozaar/​home.​html [Accessed 2003 Nov]
31.
32.
go back to reference Sonnenberg FA, Beck JR. Markov models in medical decision making: a practical guide. Med Decis Making 1993; 13: 322–338PubMedCrossRef Sonnenberg FA, Beck JR. Markov models in medical decision making: a practical guide. Med Decis Making 1993; 13: 322–338PubMedCrossRef
33.
go back to reference Naimark D, Krahn MD, Naglie G, et al. Primer on medical decision analysis: part 5. Working with Markov processes. Med Decis Making 1997; 17: 152–159PubMedCrossRef Naimark D, Krahn MD, Naglie G, et al. Primer on medical decision analysis: part 5. Working with Markov processes. Med Decis Making 1997; 17: 152–159PubMedCrossRef
34.
go back to reference Kemeny JG, Snell JL. Finite Markov chains. New York: Springer-Verlag, 1976 Kemeny JG, Snell JL. Finite Markov chains. New York: Springer-Verlag, 1976
35.
go back to reference Palepu A, Tyndall MW, Leon H, et al. Hospital utilization and costs in a cohort of injection drug users. CMAJ 2001; 165 (4): 415–420PubMed Palepu A, Tyndall MW, Leon H, et al. Hospital utilization and costs in a cohort of injection drug users. CMAJ 2001; 165 (4): 415–420PubMed
36.
go back to reference Bjorholt I, Andersson FL, Kahan T, et al. The cost-effectiveness of ramipril in the treatment of patients at high risk of cardiovascular events. J Intern Med 2002; 251 (6): 508–517PubMedCrossRef Bjorholt I, Andersson FL, Kahan T, et al. The cost-effectiveness of ramipril in the treatment of patients at high risk of cardiovascular events. J Intern Med 2002; 251 (6): 508–517PubMedCrossRef
37.
go back to reference Statistics Canada. Health and personal care consumer price index. Series V735518, Table no. 3260001 [online]. Available from URL: www.statcan.ca [Accessed 2003 Nov] Statistics Canada. Health and personal care consumer price index. Series V735518, Table no. 3260001 [online]. Available from URL: www.statcan.ca [Accessed 2003 Nov]
38.
go back to reference Goldstein LB, Adams R, Becker K, et al. Primary prevention of ischemic stroke: a statement for healthcare professionals from the Stroke Council of the American Heart Association. Circulation 2001 Jan 2; 103 (1): 163–182PubMedCrossRef Goldstein LB, Adams R, Becker K, et al. Primary prevention of ischemic stroke: a statement for healthcare professionals from the Stroke Council of the American Heart Association. Circulation 2001 Jan 2; 103 (1): 163–182PubMedCrossRef
39.
go back to reference Briggs AH, O’Brien BJ, Blackbouse G. Thinking outside of the box. Annu Rev Public Health 2002; 23: 377–401PubMedCrossRef Briggs AH, O’Brien BJ, Blackbouse G. Thinking outside of the box. Annu Rev Public Health 2002; 23: 377–401PubMedCrossRef
40.
go back to reference Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high risk treated with regimens based on valsartan or amlodipine: the VALUE randomized trial. Lancet 2004; 363 (9426): 2022–2031PubMedCrossRef Julius S, Kjeldsen SE, Weber M, et al. Outcomes in hypertensive patients at high risk treated with regimens based on valsartan or amlodipine: the VALUE randomized trial. Lancet 2004; 363 (9426): 2022–2031PubMedCrossRef
41.
go back to reference Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 345 (12): 851–860PubMedCrossRef Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 345 (12): 851–860PubMedCrossRef
42.
go back to reference Parving HR, Lehnert H, Brochner-Mortensen J, et al. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001; 345 (12): 870–878PubMedCrossRef Parving HR, Lehnert H, Brochner-Mortensen J, et al. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001; 345 (12): 870–878PubMedCrossRef
43.
go back to reference Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2001; 345 (12): 861–869PubMedCrossRef Brenner BM, Cooper ME, de Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2001; 345 (12): 861–869PubMedCrossRef
44.
go back to reference Kassler-Taub K, Littlejohn T, Elliott W, et al. Comparative efficacy of two angiotensin II receptor antagonists, irbesartan and losartan in mild-to-moderate hypertension: irbesartan/losartan study investigators. Am J Hypertens 1998; 11 (4): 445–453PubMedCrossRef Kassler-Taub K, Littlejohn T, Elliott W, et al. Comparative efficacy of two angiotensin II receptor antagonists, irbesartan and losartan in mild-to-moderate hypertension: irbesartan/losartan study investigators. Am J Hypertens 1998; 11 (4): 445–453PubMedCrossRef
45.
go back to reference Mallion J, Siche J, Lacourciere Y. AABPM comparison of the antihypertensive profiles of the selective angiotensin II anatagonists telmisartan and losartan in patients with mild to moderate hypertension. J Hum Hypertens 1999; 13 (10): 657–664PubMedCrossRef Mallion J, Siche J, Lacourciere Y. AABPM comparison of the antihypertensive profiles of the selective angiotensin II anatagonists telmisartan and losartan in patients with mild to moderate hypertension. J Hum Hypertens 1999; 13 (10): 657–664PubMedCrossRef
46.
go back to reference Anderson OK, Neldom S. The antihypertensive effect and tolerability of candesartan cilexetil, a new generation angiotensin II antagonist, in comparison with losartan. Blood Press 1998; 7 (1), 53–59CrossRef Anderson OK, Neldom S. The antihypertensive effect and tolerability of candesartan cilexetil, a new generation angiotensin II antagonist, in comparison with losartan. Blood Press 1998; 7 (1), 53–59CrossRef
47.
go back to reference Hedner T, Oparil S, Rasmussen K, et al. A comparison of the angiotensin II antagonists valsartan and losartan in the treatment of essential hypertension. Am J Hypertens 1999; 12 (4): 414–417PubMedCrossRef Hedner T, Oparil S, Rasmussen K, et al. A comparison of the angiotensin II antagonists valsartan and losartan in the treatment of essential hypertension. Am J Hypertens 1999; 12 (4): 414–417PubMedCrossRef
48.
go back to reference Johannesson M. The cost-effectiveness of the switch towards more expensive antihypertensive drugs. Health Policy 1994; 28 (1), 1–13PubMedCrossRef Johannesson M. The cost-effectiveness of the switch towards more expensive antihypertensive drugs. Health Policy 1994; 28 (1), 1–13PubMedCrossRef
49.
go back to reference Laupacis A, Feeny D, Detsky AS, et al. How attractive does a new technology have to be to warrant adoption and utilization: tentative guidelines for using clinical and economic evaluations. CMAJ 1992; 46: 473–481 Laupacis A, Feeny D, Detsky AS, et al. How attractive does a new technology have to be to warrant adoption and utilization: tentative guidelines for using clinical and economic evaluations. CMAJ 1992; 46: 473–481
50.
go back to reference Palmer AJ, Annemans L, Roze S, et al. Cost-effectiveness of early irbesartan treatment versus control (standard antihypertensive medications excluding ACE inhibitors, other angiotensin-2 receptor antagonists, and dihydropyridine calcium channel blockers) or late irbesartan treatment in patients with type 2 diabetes, hypertension, and renal disease. Diabetes Care 2004; 27 (8): 1897–1903PubMedCrossRef Palmer AJ, Annemans L, Roze S, et al. Cost-effectiveness of early irbesartan treatment versus control (standard antihypertensive medications excluding ACE inhibitors, other angiotensin-2 receptor antagonists, and dihydropyridine calcium channel blockers) or late irbesartan treatment in patients with type 2 diabetes, hypertension, and renal disease. Diabetes Care 2004; 27 (8): 1897–1903PubMedCrossRef
51.
go back to reference Nordmann AJ, Krahn M, Logan AG, et al. The cost effectiveness of ACE inhibitors as first-line antihypertensive therapy. Pharmacoeconomics 2003; 21 (8): 573–585PubMedCrossRef Nordmann AJ, Krahn M, Logan AG, et al. The cost effectiveness of ACE inhibitors as first-line antihypertensive therapy. Pharmacoeconomics 2003; 21 (8): 573–585PubMedCrossRef
52.
go back to reference Kalra L, Evans A, Perez I, et al. A randomized controlled comparison of alternative strategies in stroke care. Health Technol Assess 2005; 9 (18): 1–94 Kalra L, Evans A, Perez I, et al. A randomized controlled comparison of alternative strategies in stroke care. Health Technol Assess 2005; 9 (18): 1–94
53.
go back to reference van Exel J, Koopmanschap MA, van Wijngaarden IDH. Costs of stroke and stroke services: determinants of patient costs and a comparison of costs of regular care and care organized in stroke services. Cost Eff Resour Alloc 2003; 1: 2–11PubMedCrossRef van Exel J, Koopmanschap MA, van Wijngaarden IDH. Costs of stroke and stroke services: determinants of patient costs and a comparison of costs of regular care and care organized in stroke services. Cost Eff Resour Alloc 2003; 1: 2–11PubMedCrossRef
54.
go back to reference Hamon M, Wiedermann CJ, Poole-Wilson PA, et al. Losartan for cardiovascular disease in patients with and without diabetes in the LIFE study [correspondence]. The Lancet 2002; 359 (9324): 2199–2204CrossRef Hamon M, Wiedermann CJ, Poole-Wilson PA, et al. Losartan for cardiovascular disease in patients with and without diabetes in the LIFE study [correspondence]. The Lancet 2002; 359 (9324): 2199–2204CrossRef
55.
go back to reference Carlberg B, Samuelsson O, Lindholm LH. Atenolol in hypertension: is it a wise choice? Lancet 2004; 364: 1684–1689PubMedCrossRef Carlberg B, Samuelsson O, Lindholm LH. Atenolol in hypertension: is it a wise choice? Lancet 2004; 364: 1684–1689PubMedCrossRef
56.
go back to reference Klingbeil AU, Schneider M, Martus P, et al. A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension. Am J Med 2003; 115: 41–46PubMedCrossRef Klingbeil AU, Schneider M, Martus P, et al. A meta-analysis of the effects of treatment on left ventricular mass in essential hypertension. Am J Med 2003; 115: 41–46PubMedCrossRef
57.
go back to reference PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358: 1033–1041CrossRef PROGRESS Collaborative Group. Randomised trial of a perindopril-based blood-pressure-lowering regimen among 6105 individuals with previous stroke or transient ischaemic attack. Lancet 2001; 358: 1033–1041CrossRef
58.
go back to reference The Canadian hypertension education program recommendations [online]. Available from URL: http://www.cmaj.ca [Accessed 2003 Nov] The Canadian hypertension education program recommendations [online]. Available from URL: http://​www.​cmaj.​ca [Accessed 2003 Nov]
Metadata
Title
A Cost-Utility Analysis of Losartan versus Atenolol in the Treatment of Hypertension with Left Ventricular Hypertrophy
Authors
Dr Aslam H. Anis
Huiying Sun
Sonia Singh
John Woolcott
Bohdan Nosyk
Marc Brisson
Publication date
01-04-2006
Publisher
Springer International Publishing
Published in
PharmacoEconomics / Issue 4/2006
Print ISSN: 1170-7690
Electronic ISSN: 1179-2027
DOI
https://doi.org/10.2165/00019053-200624040-00008

Other articles of this Issue 4/2006

PharmacoEconomics 4/2006 Go to the issue

Correspondence

The Authors’ Reply