Zanfina Ademi1, Kumar Pasupathi, Henry Krum, Danny Liew. 1. Department of Medicine (Royal Melbourne Hospital), Melbourne EpiCentre, University of Melbourne, 7 East, Main Building, Grattan Street, Parkville, VIC, 3050, Australia, zademi@unimelb.edu.au.
Abstract
BACKGROUND: Chronic heart failure (CHF) remains an important cause of morbidity and mortality worldwide. Currently, there are no cost-effectiveness studies of eplerenone use in patients with New York Heart Association (NYHA) class II CHF. OBJECTIVE: We sought to evaluate the cost effectiveness of eplerenone compared with placebo in patients with chronic systolic heart failure and NYHA class II symptoms. METHODS AND RESULTS: A 10-year Markov model with yearly cycles was constructed to evaluate the cost effectiveness of eplerenone compared with placebo, based on data from the EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization And Survival Study in Heart Failure) study. The model classified subjects into two health states: 'Alive with CHF' and 'Dead'. Information about the cost of disease was derived from Australian Refined Diagnosis-Related Groups (AR-DRG) data. The cost of eplerenone was taken from the Australian Pharmaceutical Benefit Scheme. Utility data were derived from published sources, and a 5 % annual discount rate was applied to future costs and benefits. Over 10 years, and compared with placebo, the model predicted that eplerenone would lead to a saving of 0.5 life-years (discounted) and 0.4 quality-adjusted life-years (QALYs) per person. The net cost was (in Australian dollars [$A]) $A6,117 (discounted) per person. These equated to incremental cost-effectiveness ratios of $A12,024 per life-year saved and $A16,700 per QALY saved. Sensitivity analyses indicated that these results were robust. CONCLUSION: Eplerenone may represent a cost-effective strategy for preventing morbidity and mortality among patients with chronic systolic heart failure and NYHA class II symptoms.
BACKGROUND:Chronic heart failure (CHF) remains an important cause of morbidity and mortality worldwide. Currently, there are no cost-effectiveness studies of eplerenone use in patients with New York Heart Association (NYHA) class II CHF. OBJECTIVE: We sought to evaluate the cost effectiveness of eplerenone compared with placebo in patients with chronic systolic heart failure and NYHA class II symptoms. METHODS AND RESULTS: A 10-year Markov model with yearly cycles was constructed to evaluate the cost effectiveness of eplerenone compared with placebo, based on data from the EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization And Survival Study in Heart Failure) study. The model classified subjects into two health states: 'Alive with CHF' and 'Dead'. Information about the cost of disease was derived from Australian Refined Diagnosis-Related Groups (AR-DRG) data. The cost of eplerenone was taken from the Australian Pharmaceutical Benefit Scheme. Utility data were derived from published sources, and a 5 % annual discount rate was applied to future costs and benefits. Over 10 years, and compared with placebo, the model predicted that eplerenone would lead to a saving of 0.5 life-years (discounted) and 0.4 quality-adjusted life-years (QALYs) per person. The net cost was (in Australian dollars [$A]) $A6,117 (discounted) per person. These equated to incremental cost-effectiveness ratios of $A12,024 per life-year saved and $A16,700 per QALY saved. Sensitivity analyses indicated that these results were robust. CONCLUSION:Eplerenone may represent a cost-effective strategy for preventing morbidity and mortality among patients with chronic systolic heart failure and NYHA class II symptoms.
Authors: Hossein Mobaraki; Saber Azami-Aghdash; Ali Sarabi Asiabar; Aziz Rezapour; Mohammad Hossein Kafaei Mehr; Saeed Emamgolizadeh Journal: Med J Islam Repub Iran Date: 2017-01-13
Authors: Ken Lee Chin; Richard Ofori-Asenso; Si Si; Thomas R Hird; Dianna J Magliano; Sophia Zoungas; Danny Liew Journal: Sci Rep Date: 2019-03-01 Impact factor: 4.379
Authors: Gian Luca Di Tanna; Anna Bychenkova; Frank O'Neill; Heidi S Wirtz; Paul Miller; Briain Ó Hartaigh; Gary Globe Journal: Pharmacoeconomics Date: 2019-03 Impact factor: 4.981