TY - JOUR
T1 - The costs of treating acute heart failure
T2 - An economic analysis of the SURVIVE trial
AU - de Lissovoy, Gregory
AU - Fraeman, Kathy
AU - Salon, Jeff
AU - Woodward, Tatia Chay
AU - Sterz, Raimund
PY - 2008
Y1 - 2008
N2 - Objective: To estimate the incremental cost per life year gained with levosimendan relative to dobutamine in treatment of acute heart failure based on the Survival of Patients with Acute Heart Failure in Need of Intravenous Inotropic Support (SURVIVE) trial. Methods: SURVIVE enrolled 1,327 patients (levosimendan 664, dobutamine 663) from nine nations with 180-day survival from date of randomisation as the primary endpoint. Hospital resource utilisation was determined via clinical case reports. Unit costs were derived from hospital payment schedules for France, Germany and the UK, and represent a third-party payer perspective. Cost-effectiveness analysis was performed for a subset of the SURVIVE patient population selected in accordance with current levosimendan labeling. Results: Mortality in the levosimendan group was 26 versus 28% for dobutarnine (hazard ratio 0.91, 95% confidence interval 0.74-1.13, P=0.40). Initial hospitalisation length of stay was identical (levosimendan 14.4, dobutamine 14.5, p=0.98). Slightly lower rates of readmission were observed for levosimendan relative to dobutamine at 31 (p=0.13) and 180 days (p=0.23). Mean costs excluding study drug were equivalent for the index admission (levosimendan €5,060, dobutamine €4,952, p=0.91) and complete episode (levosimendan €5,396, dobutamine €5,275; p=0.93). Conclusion: At an acquisition cost of €600 per vial, there is at least 50% likelihood that levosimendan is cost effective relative to dobutamine if willingness to pay is equal to or greater than €15,000 per life year gained.
AB - Objective: To estimate the incremental cost per life year gained with levosimendan relative to dobutamine in treatment of acute heart failure based on the Survival of Patients with Acute Heart Failure in Need of Intravenous Inotropic Support (SURVIVE) trial. Methods: SURVIVE enrolled 1,327 patients (levosimendan 664, dobutamine 663) from nine nations with 180-day survival from date of randomisation as the primary endpoint. Hospital resource utilisation was determined via clinical case reports. Unit costs were derived from hospital payment schedules for France, Germany and the UK, and represent a third-party payer perspective. Cost-effectiveness analysis was performed for a subset of the SURVIVE patient population selected in accordance with current levosimendan labeling. Results: Mortality in the levosimendan group was 26 versus 28% for dobutarnine (hazard ratio 0.91, 95% confidence interval 0.74-1.13, P=0.40). Initial hospitalisation length of stay was identical (levosimendan 14.4, dobutamine 14.5, p=0.98). Slightly lower rates of readmission were observed for levosimendan relative to dobutamine at 31 (p=0.13) and 180 days (p=0.23). Mean costs excluding study drug were equivalent for the index admission (levosimendan €5,060, dobutamine €4,952, p=0.91) and complete episode (levosimendan €5,396, dobutamine €5,275; p=0.93). Conclusion: At an acquisition cost of €600 per vial, there is at least 50% likelihood that levosimendan is cost effective relative to dobutamine if willingness to pay is equal to or greater than €15,000 per life year gained.
KW - Acute heart failure
KW - Dobutamine
KW - Economic evaluation
KW - Inotropes
KW - Levosimendan
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U2 - 10.3111/13696990802291679
DO - 10.3111/13696990802291679
M3 - Article
C2 - 19450096
AN - SCOPUS:55049107613
SN - 1369-6998
VL - 11
SP - 415
EP - 429
JO - Journal of Medical Economics
JF - Journal of Medical Economics
IS - 3
ER -