The UK Prospective Diabetes Study (UKPDS) Group: Radcliffe Infirmary, Oxford; Royal Infirmary, Aberdeen; General Hospital, Birmingham; St George's Hospital and Hammersmith Hospital, London; City Hospital, Belfast; North Staffordshire Royal Infirmary, Stoke-on-Trent; Royal Victoria Hospital, Belfast; St Helier Hospital, Carshalton; Whittington Hospital, London; Norfolk & Norwich Hospital; Lister Hospital, Stevenage; Ipswich Hospital; Ninewells Hospital, Dundee; Northampton Hospital, UK.
An economic evaluation of atenolol vs. captopril in patients with Type 2 diabetes (UKPDS 54)
Article first published online: 20 DEC 2001
Volume 18, Issue 6, pages 438–444, June 2001
How to Cite
Gray, A., Clarke, P., Raikou, M., Adler, A., Stevens, R., Neil, A., Cull, C., Stratton, I., Holman, R. and the UKPDS Group (2001), An economic evaluation of atenolol vs. captopril in patients with Type 2 diabetes (UKPDS 54). Diabetic Medicine, 18: 438–444. doi: 10.1046/j.1464-5491.2001.00485.x
- Issue published online: 20 DEC 2001
- Article first published online: 20 DEC 2001
- Accepted 22 December 2000
- Type 2 diabetes;
- economic evaluation
Aims To compare the net cost of a tight blood pressure control policy with an angiotensin converting enzyme inhibitor (captopril) or β blocker (atenolol) in patients with Type 2 diabetes.
Design A cost-effectiveness analysis based on outcomes and resources used in a randomized controlled trial and assumptions regarding the use of these therapies in a general practice setting.
Setting Twenty United Kingdom Prospective Diabetes Study Hospital-based clinics in England, Scotland and Northern Ireland.
Subjects Hypertensive patients (n= 758) with Type 2 diabetes (mean age 56 years, mean blood pressure 159/94 mmHg), 400 of whom were allocated to the angiotensin converting enzyme inhibitor captopril and 358 to the β blocker atenolol.
Main outcome measures Life expectancy and mean cost per patient.
Results There was no statistically significant difference in life expectancy between groups. The cost per patient over the trial period was £6485 in the captopril group, compared with £5550 in the atenolol group, an average cost difference of £935 (95% confidence interval £188, £1682). This 14% reduction arose partly because of lower drug prices, and also because of significantly fewer and shorter hospitalizations in the atenolol group, and despite higher antidiabetic drug costs in the atenolol group.
Conclusions Treatment of hypertensive patients with Type 2 diabetes using atenolol or captopril was equally effective. However, total costs were significantly lower in the atenolol group.
Diabet. Med. 18, 438–444 (2001)