@article{17012,
  author = {Clarke P. and Rajmokan M. and Woodward Mark and Poulter N. and Alexander J. and Glasziou P. and Beller E. and Chalmers J. and Patel Anushka},
  title = {Cost-effectiveness of lowering blood pressure with a fixed combination of perindopril and indapamide in type 2 diabetes mellitus: an ADVANCE trial-based analysis},
  abstract = {<p>
OBJECTIVE: To determine the cost-effectiveness of routine administration, irrespective of blood pressure (BP), of a fixed-dose combination of perindopril and indapamide to patients with type 2 diabetes mellitus. DESIGN, SETTING AND PARTICIPANTS: Prospective cost-effectiveness analysis within the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial, an international, multicentre, randomised controlled trial of 11,140 participants with type 2 diabetes randomly allocated to receive perindopril plus indapamide (4 mg-1.25 mg/day) or placebo. MAIN OUTCOME MEASURES: Health-related quality-of-life measured by the EuroQol-5D, resource utilisation, and cost-effectiveness (cost per death averted at 4.3 years' average follow-up, and estimated cost per life-year gained, by extrapolation). RESULTS: The mean health-related quality-of-life score of survivors was 0.80 (on a 0-1 scale [death to full health]), with no difference between treatment groups. Active treatment reduced hospital admissions for coronary heart disease and coronary revascularisation by 5%. For the Australian participants, perindopril-indapamide cost A$1368 per patient during the trial period, but reduced total hospitalisation costs by A$410 and other medication costs (mainly other BP-lowering drugs) by A$332. The absolute reduction in all-cause mortality for the active treatment group was 1.1%, giving a cost per life saved of A$49,200. Lifetime extrapolation gave an estimated cost per life-year saved of A$10,040 (discounted at 5% per year). CONCLUSION: The combination of perindopril and indapamide in patients with type 2 diabetes appears to be cost-effective. TRIAL REGISTRATION: United States National Library of Medicine NCT00145925.
</p>
},
  year = {2010},
  journal = {Medical Journal of Australia},
  volume = {193},
  edition = {2010/09/22},
  number = {6},
  pages = {320-4},
  isbn = {0025-729X (Print)0025-729X (Linking)},
  note = {Glasziou, Paul PClarke, PhilipAlexander, JanRajmokan, MohanaBeller, ElaineWoodward, MarkChalmers, JohnPoulter, NeilPatel, AnushkaRandomized Controlled TrialResearch Support, Non-U.S. Gov'tAustraliaThe Medical journal of AustraliaMed J Aust. 2010 Sep 20;193(6):320-4.},
  language = {eng},
}