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Int J Clin Pract Suppl. 2001 Jan;(117):19-21.

Pharmacoeconomic impact of HOPE.

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  • 1Department of Medicine, Karolinska Hospital, Stockholm, Sweden.


The HOPE (Heart Outcomes and Prevention Evaluation) study has demonstrated a clear and beneficial effect of ramipril on cardiovascular events and disease progression. The cost-effectiveness of treatment with ramipril remains an important question that is being addressed by analysis of data from the main HOPE study and from a Swedish substudy. Data from the main HOPE study indicate that hospital costs per patient were reduced in the ramipril group compared with the placebo group. The net effect indicates that ramipril is cost neutral or could even be cost saving in US non-Medicare patients. In the Swedish health economic substudy, a separate protocol and separate case record forms were utilised to generate more specific data from the 537 Swedish patients taking part in HOPE. In this analysis, costs and effects associated with each treatment group were assessed and incremental cost-effectiveness ratios were calculated. The primary analysis was cost per life year gained which amounted to 29,000 Swedish Kroner. In a world with a growing prevalence of cardiovascular disease and with additional constraints on healthcare expenditure, analysis of the cost-effectiveness of preventive and curative medications is increasingly important. In this context, the early observations on the cost-effectiveness of ramipril appear very hopeful.

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