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Göteborgs universitets publikationer

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

Författare och institution:
J. J. McMurray (-); F. L. Andersson (-); S. Stewart (-); K. Svensson (-); A. C. Solal (-); R. Dietz (-); J. Vanhaecke (-); D. J. van Veldhuisen (-); J. Ostergren (-); C. B. Granger (-); S. Yusuf (-); M. A. Pfeffer (-); Karl Swedberg (Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin)
Publicerad i:
European heart journal, 27 ( 12 ) s. 1447-58
0195-668X (Print)
Artikel, refereegranskad vetenskaplig
Sammanfattning (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 < 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. 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.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin ->
Angiotensin II Type 1 Receptor Blockers/*economics/therapeutic use, Benzimidazoles/*economics/therapeutic use, Cardiac Pacing, Artificial/statistics & numerical data, Cost-Benefit Analysis, Drug Costs, Heart Failure, Congestive/*drug therapy/economics/mortality, Hospital Costs, Hospitalization/statistics & numerical data, Humans, Risk Factors, Survival Analysis, Tetrazoles/*economics/therapeutic use, Thoracic Surgical Procedures/statistics & numerical data
Postens nummer:
Posten skapad:
2007-09-26 11:18

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