Cost-Effectiveness Analysis of the Total Flavones of Hippophae Rhamnoides L. in Patients with Essential Hypertension_Chinese Journal of Evidence-Based Medicine

Authors：

LIAO Xiaoyang ¹ , MAO Zhengzhong ² , WANG Jialiang ³ , ZHANG Maoshun ⁴

1.Golden Care Card Hospital; West China Hospital; Sichuan University; Chengdu 610041; China2.Department of Health Economics; School of Public Health of Sichuan University3.Department of Clinical Epidemiology; West China Hospital; Sichuan University; Chengdu 610041; China4.Department of Geriatrics; West China Hospital; Sichuan University; Chengdu 610041; China;

Corresponding author：

Keywords：

Total flavones of Hippophae Rhamnoides L; Enalapril; Hypertension; Cost-effectiveness analysis （CEA）

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Objective 　To investigate the clinical effectiveness of the total Flavones of Hippophae Rhamnoides L. (TFH) and compare its cost-effectiveness ratio with enalapril in patients with essential hypertension.
Methods 　Among 3 971 staff members in two universities, 155 eligible patients with blood pressure (BP) ≥160/100 mmHg were screened and included in this study. By using a random number table, the patients were randomized to the two groups: TFH was given to the treatment group while enalapril in the control group. At the end of the six week, BP, total cost and cost-effectiveness ratio were measured in both TFH and enalapril groups.
Results 　After six weeks, blood pressures in the TFH and enalapril groups decreased by 12.7±11.6/8.1±5.1 mmHg and 15.2±9.7/10.1±7.3 mmHg respectively, while the improvement rates of BP were 73.24% (52/71) and 74.65% (53/71) respectively. There were no differences between TFH and enalapril groups in lowering BP amplitude and total effectiveness rate. The incidence of side effect in TFH group was 11.27% (8/71), which was significantly lower than that of enalapril 29.6% (21/71). The total cost of TFH group was 9 294.6 RMB with the cost effectiveness ratio of 732/1 147 RMB per mmHg and 179 RMB per case. In the enalapril group, the total cost added up to 13 236 RMB with cost effectiveness ratio of 870/1 310 per mmHg and 250 RMB per case. Sensitivity analysis indicated that TFH was better than enalapril with respect to clinical economic value even when enalapril price dropped to 1.8 RMB for tablet (5 mg).
Conclusion 　Compared with enalapril, TFH is an effective and economic drug in treating patients with hypertension.

Citation： LIAO Xiaoyang,MAO Zhengzhong,WANG Jialiang,ZHANG Maoshun. Cost-Effectiveness Analysis of the Total Flavones of Hippophae Rhamnoides L. in Patients with Essential Hypertension. Chinese Journal of Evidence-Based Medicine, 2004, 04(10): 689-692. doi: Copy

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1. ［1］Chinese Guidelines for the management of Hypertension[J]. Chinese Journal of Hypertension, 2000; 8(1): 94.
2. 中国高血压防治指南[J]. 高血压杂志, 2000; 8(1): 94.
3. ［2］Drummond MF. Methods for the economic evaluation of health care programs[M]. Oxford: Oxford University Press; 1997. p.157.
4. ［3］Xu DZ. Pharmacoeconomics and its analysis[J]. Chinese J New Drugs Clin Rem, 2000; 19(2): 139.
5. 徐端正. 药物经济学及分析[J]. 中国新药与临床杂志, 2000; 19(2): 139.
6. ［4］Alan m, Garber. Advances in cost-effectiveness analysis of health interventions[J]. Handbook of Health Economic, 2000, 1: 270-300.
7. ［5］Chen W, Hu SL. Design and analysis for pharmacoeconomics study[J]. Chinese Journal of Medicinal Guide, 2000; 2 (4): 48-50.
8. 陈文, 胡善联. 药物经济学研究设计与分析方法[J]. 中国医药导刊, 2000; 2 (4): 48～50.
9. ［6］Zhai GX, Kong Y, Cui S. Effect factor for traditional Chinese medicine entering into international market[J]. Chinese Health Economics Magazine, 2003; 22(2): 21-22.
10. 翟光喜, 孔岩, 崔爽. 我国中药行业进入国际市场影响因素分析[J]. 中国卫生经济, 2003; 22(2): 21～22.
11. ［7］Zhu F, Zhang MS, Wang JL, Fu ZY. Inhibitory Effect of total flavones of Hippophae Rhamnoides L. On angiotensin converting enzyme from rabbit[J]. Chinese Journal of clinical Pharmacy, 2000; 9(2): 95-98.
12. 朱福, 章茂顺, 王家良, 符宗胤. 醋柳黄酮对家兔血管紧张素转换酶的抑制作用[J]. 中国临床药学杂志, 2000; 9(2): 95～98.
13. ［8］Li JF, Zhang MS, Wang JL, Fu ZY, Liao XY. Effects of Quercetin on intracellular free calcium concentration in cultured rabbit aortic smooth muscle cells[J]. Chinese Journal of Hypertension, 2000; 8(1): 55-57.
14. 李家福, 章茂顺, 王家良, 符宗胤, 廖晓阳. 槲皮素对家兔血管平滑肌细胞胞内游离钙浓度的影响[J]. 高血压杂志, 2000; 8(1): 55～57.
15. ［9］Gong M, Liao XY, Zhang MS, Wang JL, Fu ZY. The effect of total flavones of Hippophae Rhamnoides L. On intraerythrocytic free calcium concentration and insulin sensitivity of hypertensive patients[J]. Modern Journal of Intergated Chinese Traditional and Western Medicine, 2000; 9(14): 1 303-1 307.
16. 龚铭, 廖晓阳, 章茂顺, 王家良, 符宗胤. 醋柳黄酮对高血压游离钙及胰岛素敏感性的影响[J]. 现代中西医结合杂志, 2000; 9(14): 1 303～1 307.
17. ［10］Mitchell A. Update and evaluation of Australian guidelines perspective[J]. Medical Care, 1996; 34(12): 216.
18. ［11］Menon D. Canada new guidelines for the economics evaluation of pharmaceuticals[J]. Medical Care, 1996; 34(12): 77.
19. ［12］Bombardier C, Maetzel A. Pharmacoeconomic evaluation of new treatment: efficacy versus effectiveness studies. The annals of the rheumatic diseases, 1999; 58(suppl): 182.

Chinese Journal of Evidence-Based Medicine

Cost-Effectiveness Analysis of the Total Flavones of Hippophae Rhamnoides L. in Patients with Essential Hypertension

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