dc.contributor.author |
Lung, Thomas |
en |
dc.contributor.author |
Jan, Stephen |
en |
dc.contributor.author |
de Silva, H Asita |
en |
dc.contributor.author |
Guggilla, Rama |
en |
dc.contributor.author |
Maulik, Pallab K |
en |
dc.contributor.author |
Naik, Nitish |
en |
dc.contributor.author |
Patel, Anushka |
en |
dc.contributor.author |
de Silva, Arjuna P |
en |
dc.contributor.author |
Rajapakse, Senaka |
en |
dc.contributor.author |
Ranasinghe, Gotabhaya |
en |
dc.contributor.author |
Prabhakaran, Dorairaj |
en |
dc.contributor.author |
Rodgers, Anthony |
en |
dc.contributor.author |
Salam, Abdul |
en |
dc.contributor.author |
Selak, Vanessa |
en |
dc.contributor.author |
Stepien, Sandrine |
en |
dc.contributor.author |
Thom, Simon |
en |
dc.contributor.author |
Webster, Ruth |
en |
dc.contributor.author |
Lea-Laba, Tracey |
en |
dc.contributor.author |
TRIUMPH Study Group |
en |
dc.date.accessioned |
2020-08-16T00:30:50Z |
en |
dc.date.issued |
2019-10 |
en |
dc.identifier.citation |
The Lancet. Global Health 7(10):e1359-e1366 Oct 2019 |
en |
dc.identifier.issn |
2214-109X |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/52538 |
en |
dc.description.abstract |
BACKGROUND:Elevated blood pressure incurs a major health and economic burden, particularly in low-income and middle-income countries. The Triple Pill versus Usual Care Management for Patients with Mild-to-Moderate Hypertension (TRIUMPH) trial showed a greater reduction in blood pressure in patients using fixed-combination, low-dose, triple-pill antihypertensive therapy (consisting of amlodipine, telmisartan, and chlorthalidone) than in those receiving usual care in Sri Lanka. We aimed to assess the cost-effectiveness of the triple-pill strategy. METHODS:We did a within-trial (6-month) and modelled (10-year) economic evaluation of the TRIUMPH trial, using the health system perspective. Health-care costs, reported in 2017 US dollars, were determined from trial records and published literature. A discrete-time simulation model was developed, extrapolating trial findings of reduced systolic blood pressure to 10-year health-care costs, cardiovascular disease events, and mortality. The primary outcomes were the proportion of people reaching blood pressure targets (at 6 months from baseline) and disability-adjusted life-years (DALYs) averted (at 10 years from baseline). Incremental cost-effectiveness ratios were calculated to estimate the cost per additional participant achieving target blood pressure at 6 months and cost per DALY averted over 10 years. FINDINGS:The triple-pill strategy, compared with usual care, cost an additional US$9·63 (95% CI 5·29 to 13·97) per person in the within-trial analysis and $347·75 (285·55 to 412·54) per person in the modelled analysis. Incremental cost-effectiveness ratios were estimated at $7·93 (95% CI 6·59 to 11·84) per participant reaching blood pressure targets at 6 months and $2842·79 (-28·67 to 5714·24) per DALY averted over a 10-year period. INTERPRETATION:Compared with usual care, the triple-pill strategy is cost-effective for patients with mild-to-moderate hypertension. Scaled up investment in the triple pill for hypertension management in Sri Lanka should be supported to address the high population burden of cardiovascular disease. FUNDING:Australian National Health and Medical Research Council. |
en |
dc.format.medium |
Print-Electronic |
en |
dc.language |
eng |
en |
dc.relation.ispartofseries |
The Lancet. Global Health |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.rights.uri |
https://creativecommons.org/licenses/by-nc-nd/4.0/ |
en |
dc.subject |
TRIUMPH Study Group |
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dc.subject |
Humans |
en |
dc.subject |
Hypertension |
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dc.subject |
Antihypertensive Agents |
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dc.subject |
Cost-Benefit Analysis |
en |
dc.subject |
Sri Lanka |
en |
dc.subject |
Australia |
en |
dc.title |
Fixed-combination, low-dose, triple-pill antihypertensive medication versus usual care in patients with mild-to-moderate hypertension in Sri Lanka: a within-trial and modelled economic evaluation of the TRIUMPH trial. |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1016/s2214-109x(19)30343-2 |
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pubs.issue |
10 |
en |
pubs.begin-page |
e1359 |
en |
pubs.volume |
7 |
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dc.rights.holder |
Copyright: The authors |
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pubs.end-page |
e1366 |
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pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/OpenAccess |
en |
pubs.subtype |
Comment |
en |
pubs.subtype |
Research Support, Non-U.S. Gov't |
en |
pubs.subtype |
Journal Article |
en |
pubs.elements-id |
782680 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
Population Health |
en |
pubs.org-id |
Epidemiology & Biostatistics |
en |
dc.identifier.eissn |
2214-109X |
en |
pubs.record-created-at-source-date |
2019-09-04 |
en |
pubs.dimensions-id |
31477545 |
en |