Resource utilization and costs in the Candesartan in Heart failure

Autor: Dirk J. van Veldhuisen, Alain Cohen Solal, Salim Yusuf, Karl Swedberg, Fredrik L. Andersson, Rainer Dietz, Simon Stewart, Johan Vanhaecke, Jan Östergren, Marc A. Pfeffer, Klas Svensson, John J.V. McMurray, Christopher B. Granger
Přispěvatelé: Cardiovascular Centre (CVC)
Jazyk: angličtina
Rok vydání: 2006
Předmět:
medicine.medical_specialty
PROGNOSIS
Heart disease
Cost effectiveness
Cost-Benefit Analysis
Population
Tetrazoles
heart failure
Placebo
Drug Costs
law.invention
EJECTION FRACTION
Randomized controlled trial
Risk Factors
law
SWEDEN
Humans
Medicine
health economics
Hospital Costs
angiotensin receptor blocker
Intensive care medicine
education
CONVERTING-ENZYME INHIBITORS
cost-effectiveness
POPULATION
education.field_of_study
business.industry
Biphenyl Compounds
Cardiac Pacing
Artificial
CARDIAC-INSUFFICIENCY
Cost-effectiveness analysis
Thoracic Surgical Procedures
medicine.disease
Survival Analysis
TRENDS
VENTRICULAR SYSTOLIC DYSFUNCTION
Hospitalization
Candesartan
Heart failure
Emergency medicine
Benzimidazoles
TRIAL
Cardiology and Cardiovascular Medicine
business
BURDEN
Angiotensin II Type 1 Receptor Blockers
medicine.drug
Zdroj: European Heart Journal, 27(12), 1447-1458. Oxford University Press
ISSN: 1522-9645
0195-668X
DOI: 10.1093/eurheartj/ehl016
Popis: Aims More treatments are needed to improve clinical outcomes in chronic heart failure (HF). It is, however, important that treatments for a condition as common as HF are affordable. We have carried out a prospective economic analysis of the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme. Methods and results Patients with NYHA class II–IV HF and LVEF � 0.40 were randomized to CHARM-Alternative if intolerant of an ACE-inhibitor or to CHARM-Added if taking an ACE-inhibitor. Patients with a LVEF .0.40 were randomized in CHARM-Preserved. Each trial compared the effect of candesartan to placebo on the primary outcome of cardiovascular death or HF hospitalization. Detailed information was prospectively collected on hospital admissions, procedures/operations and drugs. A cost–consequence analysis was performed for France, Germany and the UK for CHARM-Overall and a costeffectiveness analysis for the low LVEF trials. The cost of candesartan was substantially offset by a reduction in hospital admissions, especially for HF. In the cost–consequence analysis, candesartan was cost-saving in most scenarios for CHARM-Alternative and Added but the marginal annual net cost per patient was upto E372 per year in CHARM-Preserved, in which candesartan did not reduce the primary outcome significantly. In the cost-effectiveness analysis of patients with a LVEF � 0.40, candesartan was cost-saving in some scenarios and in the others the maximum cost per life year gained was E3881. Conclusion Candesartan improves functional class, reduces the risk of hospital admission, and increases survival in patients with a HF and a LVEF � 0.40 at an acceptable cost.
Databáze: OpenAIRE
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