Reply to comment on Cost of poor adherence to anti-hypertensive therapy in five European country

Autor: Pierre L. Levy, Roland E. Schmieder, M. Soro, Gianandrea Staffiero, Aldo P. Maggioni, F.S. Mennini, Jan Zeidler, Alastair Gray, J.-M. Graf von der Schulenburg, Paolo Sciattella, Andrea Marcellusi
Rok vydání: 2015
Předmět:
Zdroj: The European journal of health economics : HEPAC : health economics in prevention and care. 16(8)
ISSN: 1618-7601
Popis: We wish to thank the Editor for giving us the opportunity to respond to the points raised by Prof. Afschin Gandjour, who has questioned the repeatability of the results based on the input data listed in the publication. Prof. Gandjour illustrates his point of view suggesting two steps to estimate the net cost of making one additional patient adherent to blood pressure (BP) treatment. Our model is based on the decision tree described in Fig. 1 of the article [1], which we used alongside the data reported in Tables 1 and 2 of the article to populate the model and simulate the results. For example, consider the case of a diagnosed female in Italy. Figure 1 summarizes the decision tree for an Italian subject who has an adherence equal to 41.5 % (red cell in the figure). Event probabilities (light green cell) were reported considering the data in Table 1 of our article [1], while probability transitions for the controlled and uncontrolled state (light blue cell) were extrapolated from Table 2 of our article [1]. Applying these parameters to the population estimated in Italy (yellow cell), we estimated the number of events for each sex and disease state (Fig. 2). Finally, subjects were multiplied by €280 and events were multiplied by €3.393 (Table 3 of the article) assuming that all patients diagnosed were treated, with the only difference being that some patients had lower adherence (\80 %) than others. Applying the same methods to consider a scenario with increasing adherence for diagnosed subjects, we estimated the costs after 10 years in case of adherence equal to 70 % (red cell in Fig. 3). Table 1 summarizes the results for male and female diagnosed subjects in Italy considering the simulation previously described. Total costs reported in Table 1 are available in Table 4 of our article [1]. Regarding the first point commented on by Prof. Gandjour, the ‘‘transparency and repeatability of the results,’’ we hope that Figs. 1, 2 and 3 clarify the method This reply refers to the article available at doi:10.1007/s10198-015-0713-x.
Databáze: OpenAIRE
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