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Resource utilization and costs in the Candesartan in Heart failure: Assessment of Reduction in Mortality and morbidity (CHARM) programme.
- Source :
-
European heart journal [Eur Heart J] 2006 Jun; Vol. 27 (12), pp. 1447-58. - Publication Year :
- 2006
-
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.<br />Methods and Results: Patients with NYHA class II-IV HF and LVEF < or =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 372 euros 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 < or = 0.40, candesartan was cost-saving in some scenarios and in the others the maximum cost per life year gained was 3881 euros.<br />Conclusion: Candesartan improves functional class, reduces the risk of hospital admission, and increases survival in patients with a HF and a LVEF < or =0.40 at an acceptable cost.
- Subjects :
- Angiotensin II Type 1 Receptor Blockers therapeutic use
Benzimidazoles therapeutic use
Biphenyl Compounds
Cardiac Pacing, Artificial statistics & numerical data
Cost-Benefit Analysis
Drug Costs
Heart Failure economics
Heart Failure mortality
Hospital Costs
Hospitalization statistics & numerical data
Humans
Risk Factors
Survival Analysis
Tetrazoles therapeutic use
Thoracic Surgical Procedures statistics & numerical data
Angiotensin II Type 1 Receptor Blockers economics
Benzimidazoles economics
Heart Failure drug therapy
Tetrazoles economics
Subjects
Details
- Language :
- English
- ISSN :
- 0195-668X
- Volume :
- 27
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- European heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 16754631
- Full Text :
- https://doi.org/10.1093/eurheartj/ehl016