Amlodipine treatment in patients undergoing PTCA in the UK: a cost-effectiveness analysis

The objective of this analysis was to assess the health economic outcomes of treating patients undergoing percutaneous transluminal coronary angioplasty (PTCA) with amlodipine over a four-month time period in the UK. Thetotal expected costs were determined and compared for patients using amlodipine versus those on placebo following an initial angioplasty. A decision tree model was constructed to estimate these total expected costs. Clinical data for the model were obtained from the Coronary Angioplasty Amlodipine Restenosis Study (CAPARES). Clinical outcomes in the model included myocardial infarction (MI), repeat PTCA, coronary artery bypass grafting (CABG) and all-cause mortality. Resource usage and economic data for the model were produced through the use of a modified Delphi panel and various economic literature and databases. The adjunctive use of amlodipine with PTCA decreased the rate of all adverse clinical outcomes by 9.4%. This improved clinical outcome led to a decrease in overall four-month costs per patient using amlodipine of £204. The total expected cost per patient using amlodipine was £3,833 and the total expected cost per patient not using amlodipine was £4,037.