Cost effectiveness of beta blocker therapy for patients with chronic severe heart failure in Ireland.

Management of heart failure is estimated to consume 1% to 2% of total healthcare resources and recent data from the UK suggests this may be as high as 4% with hospital admissions accounting for approximately 70% of this expenditure. The safety and efficacy of b-blockers when added to standard therapy i.e. ACE inhibitors in chronic heart failure has recently been demonstrated in large placebo controlled trials. The ability of b-blockers to reduce hospital admission rates would be expected to prove cost effective. In this study the cost effectiveness of the b-blocker carvedilol when added to standard therapy in patients with severe heart failure was determined. Using economic modelling techniques and Irish cost data the incremental cost effectiveness ratio (ICER) for carvedilol therapy was 1,560 Euro per life year gained (LYG). Sensitivity analysis demonstrated an ICER range of 1,560 Euro/LYG to 7,322 Euro/LYG under a variety of assumptions. This suggests that carvedilol therapy for patients with severe chronic heart failure is not only safe and effective but is highly cost effective in the Irish healthcare setting.