Cost Effectiveness Analysis Study between Atenolol and Amlodipine in Essential Hypertension

The primary objective of study was to perform a cost effectiveness analysis study between Tab. Atenolol (50mg OD) and Tab. Amlodipine (5mg OD) in treatment of essential hypertension as a mono-therapy. The secondary objective was to evaluate and compare the tolerability of study medications.

This observational, prospective, comparative, parallel group, phase IV study was conducted at District Civil Hospital over a period of 8 weeks. Total 300 patients fulfilling the inclusion criteria i.e. having essential hypertension and receiving monotherapy of either Amlodipine or Atenolol were selected for the study after written informed consent. There were 150 patients each in Atenolol group (50mg OD) and Amlodipine group (5mg OD). Unit costs of atenolol and amlodipine were applied to the daily dosages of individual patients to calculate the total costs and average costs per patient in each treatment group on an intent-to-treat basis. Efficacy rates were used to calculate the average treatment cost per unit (10 mm of Hg) reduction in Mean Arterial Pressure (MAP). The MAP was calculated at baseline visit and at final visit (at the end of 8 weeks).

Tab. Amlodipine (5mg) OD required less cost i.e. Rs.3.43/pt. as compared to Tab.Atenolol (50mg) OD i.e Rs. 5.05/pt. for the reduction of MAP by one unit (i.e. 10 mm Hg). There was no statistically significant difference between average MAP reduction in Amlodipine monotherapy (17.49 mm Hg) Vs Atenolol monotherapy (16.61 mm Hg). Although not statistically significant, Amlodipine treatment resulted in a higher ADRs (23.33%) vs. Atenolol (18.66%)

This study concludes that Amlodipine monotherapy is more cost effective compared with an Atenolol monotherapy.