A pharmacoeconomic study of captopril, enalarpil, and lisinopril using data from the State Register of Maximum Selling Prices

I n t r o d u c t i o n . Arterial hypertension (AH) is a serious problem of modern medicine. High blood pressure significantly increases the risk of dangerous cardiovascular complications.
A i m . To perform a pharmacoeconomic cost-effectiveness analysis of angiotensin-converting enzyme inhibitors (ACE inhibitors) – captopril, enalapril, and lisinopril using data from the State Register of Maximum Selling Prices. 
M a t e r i a l s a n d m e t h o d s . Data on the clinical effectiveness of the studied ACE inhibitors was obtained from literature sources. The level of reduction of elevated blood pressure (systolic and diastolic) was considered as the criterion of clinical efficacy. The costs of pharmacotherapy were calculated based on the data from the State Register of Medicines. To perform a cost-effectiveness analysis (CEA), the cost-effectiveness ratio (CER) was calculated for captopril, lisinopril, and enalapril in order to determine the most cost-effective ACE inhibitor with the minimum CER value. The CEA was performed in 3 variants: CEA No. 1 – calculation of CER for 20 subgroups (CER separately for each dose that demonstrated clinical effectiveness); CEA No. 2 – calculation of CER separately for each dose, the price of which was used to calculate the costs; CEA No. 3 – calculation of CER for all doses simultaneously.
R e s u l t s . The CER values for enalapril at a daily dose of 20 mg, achieved by taking four 5 mg tablets, were statistically significantly lower than the CER values for captopril and lisinopril when assessing clinical effectiveness by normalizing systolic blood pressure (SBP). It was also found that the CER values for enalapril at a daily dose of 20 mg (8 tablets at a dose of 2,5 mg) were statistically significantly lower than the CER values for captopril and lisinopril when assessing clinical effectiviness by normalizing diastolic blood pressure (DBP).
C o n c l u s i o n . A cost-effectiveness analysis of ACE inhibitors showed that enalapril 20 mg/day is more costeffective than captopril and lisinopril for normalizing SBP and DBP.

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