Decision-analytic evaluation of the clinical effectiveness and cost-effectiveness of management programmes in chronic heart failure

Item Type:	Article
Title:	Decision-analytic evaluation of the clinical effectiveness and cost-effectiveness of management programmes in chronic heart failure
Creators Name:	Goehler, A. and Conrads-Frank, A. and Worrell, S.S. and Geisler, B.P. and Halpern, E.F. and Dietz, R. and Anker, S.D. and Gazelle, G.S. and Siebert, U.
Abstract:	BACKGROUND AND AIMS: While management programmes (MPs) for chronic heart failure (CHF) are clinically effective, their cost-effectiveness remains uncertain. Thus, this study sought to determine the cost-effectiveness of MPs. METHODS AND RESULTS: We developed a Markov model to estimate life expectancy, quality-adjusted life expectancy, lifetime costs, and the incremental cost-effectiveness of MPs as compared to standard care. Standard care was defined by the EuroHeart Failure Survey for Germany, MP efficacy was derived from our recent meta-analysis and cost estimates were based on the German healthcare system. For a population with a mean age 67 years (35% female) at onset of CHF, our model predicted an average quality-adjusted life expectancy of 2.64 years for standard care and 2.83 years for MP. MP yielded additional lifetime costs of euro1700 resulting in an incremental cost-utility ratio (ICUR) of euro8900 (95% CI: dominant to 177,100) per quality-adjusted life year (QALY) gained. Sensitivity analyses demonstrated that the ICUR was sensitive to age and sex. CONCLUSION: MPs increase life expectancy in patients with CHF by an average of 84 days and increase lifetime cost of care by approximately euro1700. MPs improve outcomes in a cost-effective manner, although they are not cost-saving on a lifetime horizon.
Keywords:	Hearth Failure, Management Programme, Cost-Effectiveness Analysis, Markov Model
Source:	European Journal of Heart Failure
ISSN:	1388-9842
Publisher:	Oxford University Press
Volume:	10
Number:	10
Page Range:	1026-1032
Date:	October 2008
Official Publication:	https://doi.org/10.1016/j.ejheart.2008.07.018
PubMed:	View item in PubMed

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