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Cost-Effectiveness of Antihypertensive Treatment

Metoprolol versus Thiazide Diuretics

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Summary

The aim of the present analysis was to calculate the cost-effectiveness of metoprolol versus thiazide diuretics in middle-aged men with mild to moderate uncomplicated hypertension. The analysis was based on the Metoprolol Atherosclerosis Prevention in Hypertensives (MAPHY) study, a randomised trial which showed a significantly lower risk for coronary events in patients taking metoprolol than in patients on thiazide diuretics. The main analysis was based on Swedish costs, but the costs were also varied in a special sensitivity analysis. Metoprolol was shown to be cost-saving compared with thiazide diuretics when both direct and indirect costs of morbidity were included. When only direct costs were included, the cost per life-year gained was $US2400. The result of the present analysis suggests that metoprolol is to be preferred to thiazide diureties from a cost-effectiveness standpoint in the treatment of mild to moderate hypertension in middle-aged men. These findings regarding cost-effectiveness should, however, not be extrapolated to patient groups not included in the MAPHY trial.

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Authors and Affiliations

  1. Centre for Health Economics, Stockholm School of Economics, Box 6501, S-113 83, Stockholm, Sweden

    Magnus Johannesson

  2. Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska Hospital, Gothenburg University, Gothenburg, Sweden

    John Wikstrand

  3. Centre for Health Economics, Stockholm School of Economics, Stockholm, Sweden

    Bengt Jönsson

  4. Department of Medicine, Malmö Hospital, Lund University, Lund, Sweden

    Göran Berglund

  5. Department of Epidemiology, National Public Health Institute, Helsinki, Finland

    Jaakko Tuomilehto

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  1. Magnus Johannesson
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  2. John Wikstrand
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  3. Bengt Jönsson
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  4. Göran Berglund
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  5. Jaakko Tuomilehto
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Johannesson, M., Wikstrand, J., Jönsson, B. et al. Cost-Effectiveness of Antihypertensive Treatment. Pharmacoeconomics 3, 36–44 (1993). https://doi.org/10.2165/00019053-199303010-00005

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