Resource utilization and costs in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme

Item Type:	Article
Title:	Resource utilization and costs in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme
Creators Name:	McMurray, J.J. and Andersson, F.L. and Stewart, S. and Svensson, K. and Solal, A.C. and Dietz, R. and Vanhaecke, J. and van Veldhuisen, D.J. and Oestergren, J. and Granger, C.B. and Yusuf, S. and Pfeffer, M.A. and Swedberg, K.
Abstract:	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 cost-effectiveness 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 euro372 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 euro3881. 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.
Keywords:	Heart failure, Angiotensin receptor blocker, Health economics, Cost-effectiveness
Source:	European Heart Journal
ISSN:	0195-668X
Volume:	27
Page Range:	1447-1458
Date:	1 June 2006
Official Publication:	https://doi.org/10.1093/eurheartj/ehl016
PubMed:	View item in PubMed

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