Las combinaciones fijas en hipertensión: análisis de impacto presupuestario para el Sistema Nacional de Salud Español de la comercialización de la combinación fija de olmesartan/amlodipino

ResumenObjetivoRealizar un análisis de impacto presupuestario (AIP) de la introducción en el Sistema Nacional de Salud (SNS) de la combinación fija (CF) de olmesartan/amlodipino (20/5, 40/5 y 40/10mg) en la indicación aprobada.DiseñoModelo de árbol de decisión que refleja el algoritmo de tratamiento más habitual en la práctica clínica de la hipertensión junto con sus probabilidades de ocurrencia.EmplazamientoPerspectiva del SNS para un período de 3 años (2010-2012).ParticipantesPoblación española hipertensa mayor de 35 años.IntervencionesIntroducción de la CF olmesartan/amlodipino en el mercado español.Mediciones principalesCostes financiados por el SNS (a PVP-IVA) para la población de pacientes susceptibles de ser tratados con la CF frente a los asumidos con la combinación libre (CL) olmesartan y amlodipino.ResultadosLa estimación del gasto farmacéutico con olmesartan y amlodipino en CL era de 25,2 M€ (primer año), 26,4 M€ el segundo año y 27,6 M€ el tercero, totalizando 79,2 M€. Según el modelo, la población susceptible de ser tratada con la CF es de 71.283 pacientes (primer año), con una tasa de crecimiento cercana al 4,8% en los sucesivos años, lo que supone un coste anual de 21,2 M€ (2010), 21,8 M€ (2011) y 22,4 M€ (2012), totalizando 65,4 M€. El AIP muestra un ahorro de 13,8 M€, siendo unos resultados robustos confirmados por los análisis de sensibilidad univariantes de tipo umbral.ConclusiónEl AIP de la CF de olmesartan/amlodipino podría generar unos ahorros netos para el SNS en 3 años de 13,8 M€.AbstractObjectiveTo carry out a budget impact analysis (BIA) of olmesartan/amlodipine (20/5, 40/5 and 40/10mg) marketed as a fixed combination (FC) in its approved indication for the National Health System (NHS).DesigWe developed a decision tree model in order to estimate usual hypertension treatment algorithm in Spanish clinical practice.SettingsThe BIA has been developed from the perspective of the NHS for a period of 3 years (years 2010-2012).ParticipantsSpanish hypertensive population ≥ 35 years old.InterventionsIntroduction into the market of a fixed combination (FC) olmesartan/amlodipine in Spain.Primary measuresExpected costs to be assumed by the Spanish NHS (RRP-VAT) for hypertensive population able to be treated with the FC versus currently assumed costs by the NHS with free combination olmesartan and amlodipine.ResultsEstimated pharmaceutical costs in hypertensive population treated with olmesartan and amlodipine (2 pills) would be €25.2M (1st year), €26.4M (2011), €27.6M (2012), with a total 3-year period of €79.2M. According to patient tree model, the population able to be treated with FC would be 71,283 patients (2010), with a growth rate of 4.8% in the successive years, which supposes an annual cost of €21.2M (2010), €21.8M (2011) and €22.4M (2012), with a total 3-year period of €65.4M. The BIA shows savings of €13.8M in a total 3-year period.ConclusionThe BIA of FC olmesartan/amlodipine could generate net savings of €13.8M for the NHS in the period ranging from years 2010 to 2012

Hemiptera records from Lake Spechtensee and from Southern Styria (Austria)

Hemiptera records gained in July 2015 in course of the 7th European Hemiptera Congress in Styria are presented. In total, 144 Auchenorrhyncha, 143 Heteroptera, 13 Psylloidea and 2 Aphididae species were collected. Ribautodelphax imitans (Delphacidae), Eurhadina saageri (Cicadellidae), Notonecta maculata (Notonectidae), Notonecta meridionalis (Notonectidae) and Polymerus cognatus (Miridae) are new records for Styria

Prevalence and Clinical Features of Isolated Clinical Hypertension and Dipping Profile in a Large Cohort of Untreated Hypertensive Subjects

Aim: To examine the prevalence and clinical features of isolated clinical hypertension (ICH) and the dipping patterns in a large cohort of untreated hypertensive subjects form the Spanish ABPM registryYe

Clinical effects of torasemide prolonged release in mild-to-moderate hypertension: a randomized noninferiority trial versus torasemide immediate release

The efficacy of a new torasemide prolonged release (PR) formulation to torasemide immediate release (IR) was compared in a randomized noninferiority double‐blind trial. Patients with newly diagnosed mild‐to‐moderate hypertension or unresponsive or poor tolerability to previous antihypertensive monotherapy received 5 mg/day of torasemide‐PR (n = 219) or torasemide‐IR (n = 223) for 12 weeks (uptitration to 10 mg/day if no response at 4 or 8 weeks). Mean diastolic blood pressure (DBP) reduction in the torasemide‐PR group (11.6 ± 7.1 mmHg, 95% confidence interval [CI] 10.6-12.5) versus torasemide‐IR (11.3 ± 7.5 mmHg, 95% CI 10.2-12.3) met the noninferiority criterion of a nonsided 97.5% CI lower than the preestablished margin of 2 mmHg. A significantly higher percentage of patients in the torasemide‐PR group achieved adequate BP control after 8 and 12 weeks. Ambulatory 24‐h BP monitoring (ABPM) measurements in a subset of 100 patients showed greater daytime SBP reductions in the torasemide‐PR group (128.4 ± 9.9 mmHg vs. 133.5 ± 10.4 mmHg, P < 0.05). Safety and tolerability of both formulations were similar