Stearne, MR and Palmer, SL and Hammersley, MS and Franklin, SL and Spivey, RS and Levy, JC and Tidy, CR and Bell, NJ and Steemson, J and Barrow, BA and Coster, R and Waring, K and Nolan, L and Truscott, E and Walravens, N and Cook, L and Lampard, H and Merle, C and Parker, P and McVittie, J and Draisey, I and Murchison, LE and Brunt, AHE and Williams, MJ and Pearson, DW and Petrie, XMP and Lean, MEJ and Walmsley, D and Lyall, F and Christie, E and Church, J and Thomson, E and Farrow, A and Stowers, JM and Stowers, M and McHardy, K and Patterson, N and Wright, AD and Levi, NA and Shearer, ACI and Thompson, RJW and Taylor, G and Rayton, S and Bradbury, M and Glover, A and Smyth-Osbourne, A and Parkes, C and Graham, J and England, P and Gyde, S and Eagle, C and Chakrabarti, B and Smith, J and Sherwell, J and Kohner, EM and Dornhorst, A and Doddridge, MC and Dumskyj, M and Walji, S and Sharp, P and Sleightholm, M and Vanterpool, G and Rose, C and Frost, G and Roseblade, M and Elliott, S and Forrester, S and Foster, M and Myers, K and Chapman, R and Hayes, JR and Henry, RW and Featherston, MS and Archbold, GPR and Copeland, M and Harper, R and Richardson, I and Martin, S and Foster, M and Davison, HA and Hadden, DR and Kennedy, L and Atkinson, AB and Culbert, AM and Hegan, C and Tennet, H and Webb, N and Robinson, I and Holmes, J and Foster, M and Bell, PM and McCance, DR and Rutherford, J and Nesbitt, S and Spathis, AS and Hyer, S and Nanson, ME and James, LM and Tyrell, JM and Davis, C and Strugnell, P and Booth, M and Petrie, H and Clark, D and Rice, B and Hulland, S and Barron, JL and Yudkin, JS and Gould, BJ and Singer, J and Badenock, A and Walji, S and Eckert, M and Alibhai, K and Marriot, E and Cox, C and Price, R and Fernandez, M and Ryle, A and Clarke, S and Wallace, G and Mehmed, E and MacFarlane, S and Greenwood, RH and Wilson, J and Denholm, MJ and Temple, RC and Whitfield, K and Johnson, F and Munroe, C and Gorick, S and Duckworth, E and Flatman, M and Rainbow, S and Borthwick, LJ and Wheatcroft, DJ and Seaman, RJ and Christie, RA and Wheatcroft, W and Musk, P and White, J and McDougal, S and Bond, M and Raniga, P and Newton, RW and Jung, RT and Roxburgh, C and Kilgallon, B and Dick, L and Foster, M and Waugh, N and Kilby, S and Ellington, A and Burns, J and Fox, CV and Holloway, MC and Coghill, HM and Hein, N and Fox, A and Cowan, W and Richard, M and Quested, K and Evans, SJ and Paisey, RB and Brown, NPR and Tucker, AJ and Paisey, R and Garrett, F and Hogg, J and Park, P and Williams, K and Harvey, P and Wilcocks, R and Mason, S and Frost, J and Warren, C and Rocket, P and Bower, L and Roland, JM and Brown, DJ and Youens, J and Stanton-King, K and Mungall, H and Ball, V and Maddison, W and Donnelly, D and King, S and Griffin, P and Smith, S and Church, S and Dunn, G and Wilson, A and Palmer, K and Brown, PM and Humphriss, D and Davidson, AJM and Rose, R and Armistead, L and Townsend, S and Poon, P and Peacock, IDA and Culverwell, NJC and Charlton, MH and Connolly, BPS and Peacock, J and Barrett, J and Wain, J and Beeston, W and King, G and Hill, PG and Boulton, AJM and Robertson, AM and Katoulis, V and Olukoga, A and McDonald, H and Kumar, S and Abouaesha, F and Abuaisha, B and Knowles, EA and Higgins, S and Booker, J and Sunter, J and Breislin, K and Parker, R and Raval, P and Curwell, J and Davenport, J and Shawcross, G and Prest, A and Grey, J and Cole, H and Sereviratne, C and Young, RJ and Dornan, TL and Clyne, JR and Gibson, M and O'Connell, I and Wong, LM and Wilson, SJ and Wright, KL and Wallace, C and McDowell, D and Burden, AC and Sellen, EM and Gregory, R and Roshan, M and Vaghela, N and Burden, M and Sherriff, C and Clarke, J and Grenfell, J and Tooke, JE and MacLeod, K and Searnark, C and Rammell, M and Pym, C and Stockman, J and Yeo, C and Piper, J and Leighton, L and Green, E and Hoyle, M and Jones, K and Hudson, A and James, AJ and Shore, A and Higham, A and Martin, B and UK Prospective Diabet Study Grp, (1998) Cost effectiveness analysis of improved blood pressure control in hypertensive patients with type 2 diabetes: UKPDS 40. BRIT MED J , 317 (7160) 720 - 726.
Full text not available from this repository.
Objectives: To estimate the economic efficiency of tight blood pressure control, with angiotensin converting enzyme inhibitors or beta blockers, compared with less tight control in hypertensive patients with type 2 diabetes.Design: Cost effectiveness analysis incorporating within trial analysis and estimation of impact on life expectancy through use of the within trial hazards of reaching a defined clinical end point Use of resources driven by trial protocol and use of resources in standard clinical practice were both considered.Setting: 20 hospital based clinics in England, Scotland, and Northern Ireland.Subjects: 1148 hypertensive patients with type 2 diabetes from UK prospective diabetes study randomised to tight control of blood pressure (n = 758) or less tight control (n = 390).Main outcome measure: Cost effectiveness ratios based on (a) use of healthcare resources associated with tight control and less tight control and treatment of complications and (b) within trial time free from diabetes related end points, and life years gained.Results: Based an use of resources driven by trial protocol, the incremental cost effectiveness of tight control compared with less tight control was cost saving. Based on use of resources in standard clinical practice, incremental cost per extra year free from end points amounted to pound 1049 (costs and effects discounted at 6'% per year) and pound 434 (costs discounted at 6%, per year and effects not discounted). The incremental cost per life year gained was pound 720 (costs and effects discounted at 6% per year) and pound 291 (costs discounted at 6% per year and effects not discounted).Conclusions: Tight control of blood pressure in hypertensive patients with type 2 diabetes substantially reduced the cost of complications, increased the interval without complications and survival, and had a cost effectiveness ratio that compares favourably with many accepted healthcare programmes.
|Title:||Cost effectiveness analysis of improved blood pressure control in hypertensive patients with type 2 diabetes: UKPDS 40|
|Keywords:||CONFIDENCE-INTERVALS, EFFECTIVENESS RATIOS, NIDDM, COMPLICATIONS, PROGRAM, TRIAL, MODEL, HEART|
|UCL classification:||UCL > School of Life and Medical Sciences|
Archive Staff Only: edit this record