The costs of treating acute heart failure

An economic analysis of the SURVIVE trial

Gregory de Lissovoy, Kathy Fraeman, Jeff Salon, Tatia Chay Woodward, Raimund Sterz

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)415-429
Number of pages15
JournalJournal of Medical Economics
Volume11
Issue number3
DOIs
StatePublished - 2008
Externally publishedYes

Fingerprint

Dobutamine
Heart Failure
Economics
Costs and Cost Analysis
Health Insurance Reimbursement
simendan
Survival
Random Allocation
France
Cost-Benefit Analysis
Germany
Length of Stay
Appointments and Schedules
Hospitalization
Confidence Intervals
Mortality
Pharmaceutical Preparations
Population

Keywords

  • Acute heart failure
  • Dobutamine
  • Economic evaluation
  • Inotropes
  • Levosimendan

ASJC Scopus subject areas

  • Health Policy

Cite this

The costs of treating acute heart failure : An economic analysis of the SURVIVE trial. / de Lissovoy, Gregory; Fraeman, Kathy; Salon, Jeff; Woodward, Tatia Chay; Sterz, Raimund.

In: Journal of Medical Economics, Vol. 11, No. 3, 2008, p. 415-429.

Research output: Contribution to journalArticle

de Lissovoy, G, Fraeman, K, Salon, J, Woodward, TC & Sterz, R 2008, 'The costs of treating acute heart failure: An economic analysis of the SURVIVE trial', Journal of Medical Economics, vol. 11, no. 3, pp. 415-429. https://doi.org/10.3111/13696990802291679
de Lissovoy, Gregory ; Fraeman, Kathy ; Salon, Jeff ; Woodward, Tatia Chay ; Sterz, Raimund. / The costs of treating acute heart failure : An economic analysis of the SURVIVE trial. In: Journal of Medical Economics. 2008 ; Vol. 11, No. 3. pp. 415-429.
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