The cost-effectiveness of doxazosin for the treatment of hypertension in type II diabetic patients in the UK and Italy

The objective of this analysis was to assess the cost-effectiveness of achi eving 'tight control' versus 'less tight control' of blood pressure, as def ined in the UK Prospective Diabetics Study 38, in type II diabetic patients in the UK and Italy. The effect of including doxazosin in a 'tight control ' combination therapy was analysed, Given doxazosin's positive impact on li pid levels in addition to its antihypertensive effect, it is hypothesised t hat treatment including doxazosin will reduce the incidence of macrovascula r complications. For each country, a Markov model was constructed to simula te macrovascular outcomes of patients on various drug combinations. Transit ional probabilities were based on the risk rates presented in UKPDS 38, Ris k rates were adjusted for the ageing of the cohort and the lipid-lowering p roperties of doxazosin using Framingham risk equations. Incremental cost-ef fectiveness ratios ranged from pound 2224 to pound 4867 (US$3225-7057) per life-year saved for the UK and from L1.8-9.3 million (US$818-4159) per life -year saved for Italy. Doxazosin is a cost-effective agent when included in a combination therapy in the treatment of hypertension in the diabetic pop ulations of the UK and Italy.