Comparative Cost-effectiveness of Allisartan Isoproxil vs Other ARBs in Outpatients with Essential Hypertension in China: Evidence from a Real-world Study

To evaluate the real-world antihypertensive effectiveness and cost-effectiveness of allisartan iso-proxil compared with valsartan and irbesartan drugs. We reviewed the clinical data of all consecutive out-patients who were treated with allisartan isoproxil, valsartan or irbesartan between January 2018 and June 2021 from a tertiary hospital for cardiovascular diseases in central China. Whether it was monotherapy or combination antihypertensive therapy, we defined the groups based on baseline ARBs as the allisartan iso-proxil group, valsartan group and irbesartan group. An Inverse Probability Weighted Regression Adjustment (IPWRA) was used to minimize the bias due to potential confounding variables and eventfully to increase the reliability of all parameters. Our inverse probability weighted regression results suggest that the allisartan isoproxil group had a higher BP control rate (74.8% vs. 70.9% vs. 62.5%; P< 0.001) compared with valsartan group and irbesartan group. The allisartan isoproxil group yielded an incremental cost per incremental avert-ed DALY (incremental cost-effectiveness ratio, ICER) of 722,043.54 RMB and 240,486.38 RMB compared with the valsartan group and irbesartan group respectively. As a brand-name drug included in CNHID, re-sults from the real-world data gained in this research has shown that allisartan isoproxil has positive effects in the improvement of BP control rate. However, on the principle of value-based pricing and an WTP threshold, compared to valsartan or irbesartan, allisartan isoproxil does not present good value to money on current price.