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

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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., Andersson, F.L., Stewart, S., Svensson, K., Solal, A.C., Dietz, R., Vanhaecke, J., van Veldhuisen, D.J., Oestergren, J., Granger, C.B., Yusuf, S., 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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