Kosteneffektivität von Perindopril bei Patienten mit koronarer Herzkrankheit in der Schweiz - eine Analyse der EUROPA-Studie

Background: The efficacy of therapy for coronary heart disease with ACE inhibitors has been documented in clinical investigations. The EUROPA study has backed up the clinical usefulness of the ACE inhibitor perindopril in a dose of 8 mg/day in patients with stable coronary heart disease without cardiac failure. This provides an opportunity of evaluating the cost-effectiveness of this therapy in the context of the Swiss healthcare system. Patients and methods: The cost-effectiveness of perindopril was evaluated on the basis of EUROPA study results by incremental costeffectiveness analysis. All costs were evaluated from the viewpoint of compulsory sickness insurance. Effectiveness was computed as life years gained, using epidemiological modelling. Costs and effectiveness were subjected to univariate sensitivity analysis. Results: The incremental costs amount to CHF 1684 (1108 euro) in the group treated with perindopril. Life years gained by the therapy (mean duration 4.2 yr) amount to 0.167 per patient. The resultant cost effectiveness of perindopril therapy in Switzerland amounts, discounted, to CHF 10 086 (6636 euro) per life year gained. The soundness of this result was backed by an extensive sensitivity analysis, with costs of CHF 5758 (3788 euro) to CHF 16 809 (11 059 euro) per life year saved. Conclusion: Administration of 8 mg perindopril in patients with stable coronary heart disease in Switzerland shows a comparatively favourable cost-effectiveness ratio.