Cost analysis of once-daily ISMN versus twice-daily ISMN or transdermal patch for nitrate prophylaxis
Brown, R. E., Kendall, M. J., & Halpern, M. (1997). Cost analysis of once-daily ISMN versus twice-daily ISMN or transdermal patch for nitrate prophylaxis. Journal of Clinical Pharmacy and Therapeutics, 22(1), 67-76.
OBJECTIVE: To compare the costs and outcomes of treating exercise-induced angina with once- or twice-daily isosorbide mononitrate (ISMN) or transdermal patch. METHOD: A decision-analytic model was designed based on published literature showing compliance and increasing symptoms and estimates from physicians on treatment patterns and worsening symptoms. RESULTS: Data show that patients are more compliant with once-daily ISMN (Imdur, Astra Hassle, Molndal, Sweden) and patch regimens than with twice-daily dose. Based upon the assumption that more compliant patients are better controlled, the model found that fewer medical care resources were consumed by patients treated with the once-daily and the patch regimens. The unit cost of the twice-daily ISMN regimen is 40% of the unit cost of the once-daily. Annual costs of treating an exercise-induced angina patient are 248 pounds for Imdur compared to 250 pounds for the twice-daily ISMN and 299 pounds for the transdermal patch. CONCLUSION: Unit prices alone are not good indicators for estimating medical management costs