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Budget impact analysis of increasing prescription of renin-angiotensin system inhibitors drugs to standard anti-hypertensive treatments in patients with diabetes and hypertension in a hypothetical cohort of Malaysian population
- Source :
- PLoS ONE, Vol 14, Iss 2, p e0212832 (2019), PLoS ONE
- Publication Year :
- 2019
- Publisher :
- Public Library of Science (PLoS), 2019.
-
Abstract
- IntroductionRenin-angiotensin system inhibitors (RAS) drugs have a proteinuria-reducing effect that could prevent the progression of kidney disease in diabetic patients. Our study aimed to assess the budget impact based on healthcare payer perspective of increasing uptake of RAS drugs into the current treatment mix of standard anti-hypertensive treatments to prevent progression of kidney disease in patient's comorbid with hypertension and diabetes.MethodsA Markov model of a Malaysian hypothetical cohort aged ≥30 years (N = 14,589,900) was used to estimate the total and per-member-per-month (PMPM) costs of RAS uptake. This involved an incidence and prevalence rate of 9.0% and 10.53% of patients with diabetes and hypertension respectively. Transition probabilities of health stages and costs were adapted from published data.ResultsAn increasing uptake of RAS drugs would incur a projected total treatment cost ranged from MYR 4.89 billion (PMPM of MYR 27.95) at Year 1 to MYR 16.26 billion (PMPM of MYR 92.89) at Year 5. This would represent a range of incremental costs between PMPM of MYR 0.20 at Year 1 and PMPM of MYR 1.62 at Year 5. Over the same period, the care costs showed a downward trend but drug acquisition costs were increasing. Sensitivity analyses showed the model was minimally affected by the changes in the input parameters.ConclusionMild impact to the overall healthcare budget has been reported with an increased utilization of RAS. The long-term positive health consequences of RAS treatment would reduce the cost of care in preventing deterioration of kidney function, thus offsetting the rising costs of purchasing RAS drugs. Optimizing and increasing use of RAS drugs would be considered an affordable and rational strategy to reduce the overall healthcare costs in Malaysia.
- Subjects :
- Budgets
Financial Management
Economics
Cost-Benefit Analysis
Peptide Hormones
Social Sciences
Angiotensin-Converting Enzyme Inhibitors
Blood Pressure
Comorbidity
Biochemistry
Vascular Medicine
Cohort Studies
Renin-Angiotensin System
Endocrinology
0302 clinical medicine
Chronic Kidney Disease
Prevalence
Medicine and Health Sciences
Diabetic Nephropathies
030212 general & internal medicine
health care economics and organizations
Multidisciplinary
Pharmaceutics
Incidence
Incidence (epidemiology)
Drugs
myr
Health Care Costs
030210 environmental & occupational health
Models, Economic
Antihypertensive Drugs
Nephrology
Hypertension
Cohort
Disease Progression
Medicine
Anatomy
Research Article
Cohort study
Adult
medicine.medical_specialty
Endocrine Disorders
Science
Angiotensin Receptor Antagonists
03 medical and health sciences
Drug Therapy
Cost Savings
Internal medicine
Diabetes mellitus
Diabetes Mellitus
medicine
Humans
Medical prescription
Antihypertensive Agents
Pharmacology
business.industry
Malaysia
Biology and Life Sciences
Kidneys
Renal System
medicine.disease
Hormones
Diabetes Mellitus, Type 2
Metabolic Disorders
business
Finance
Kidney disease
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Volume :
- 14
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- PLoS ONE
- Accession number :
- edsair.doi.dedup.....c970c8e5672dbe822c3cd7a70ee51192