JO INTERNATIONAL RESEARCH & OPINION

Celiprolol more effective than atenolol in reducing coronary risk

Celiprolol is more effective than atenolol at reducing coronary risk, at a similar 5-year net direct medical cost, report researchers in New Zealand. *

They note that the beneficial effect of celiprolol on coronary risk is enhanced by its positive effect on serum lipid levels, while the detrimental effect of atenolol on serum lipid levels attenuates its beneficial effect on coronary risk.

The researchers developed a predictive model to determine the effects of 5 years' treatment with atenolol or celiprolol on systolic BP, serum lipids and cardiovascular risk in patients with mild-to-moderate hypertension. The cost effectiveness of both treatments was determined from a partial societal perspective.

Data on the antihypertensive and lipid effects of both drugs were obtained from a pooled analysis of 16 published studies. The 5-year absolute risks of coronary events, cerebrovascular events and cardio­vascular death were estimated using data from the Framingham Heart Study. Costs were direct medical costs incurred to the government, insurer and patient in New Zealand and included drug acquisition, and the treatment of coronary and stroke events.**

Tw~fold more effective The model revealed that in the lowest-risk base caset

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ceJiprolol was 2-fold more effective than atenolol in reducing coronary event risk, and equally effective in reducing cerebrovascular event risk. 29 and 105 individuals would have to be treated with ceJiprolol to prevent 1 coronary event and 1 cardiovascular death, respectively, whereas 68 and 148 individuals would have to be treated with atenolol, respectively.

For the base-case scenario, the cost per life-year gained was found to be significantly lower with ceJiprolol, compared with atenolol ($NZ19 640 vs $NZ26 746, respectively). Both drugs were shown to be cost effective by international standards in the treatment of patients with a 5-year absolute cardio­vascular risk of> 10%. * Their study was funded by RhOne-Poulenc Rorer. NZ. ** expressed in 1997 values t The lowest-risk base case comprised 60-year-old men who were not smokers, who did not have diabetes mellitus, who had a systolic BP of l60mm Hg and a 5-yearabsolute cardiovascular risk of 12%. Milne RJ. Hoorn SV, Jackson RT. A predictive model of the health benefits and cost effectiveness of ce1iprolol and atenolol in primary prevention of cardiovascular disease in hypenensive patients. PharmacoEconomics 12: 384-408, Sep 1997 800>,,'"

PhanT18COEconomics & Outcomes News 15 Nov 1997 No. 138 1173-5503197/0138-000101$01.00° Adi. International Limited 1997. All right. reserved