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

Alexander Göhler, Annette Conrads-Frank, Stewart S. Worrell, Benjamin P. Geisler, Elkan F. Halpern, Rainer Dietz, Stefan D. Anker, G. Scott Gazelle, Uwe Siebert

Research output: Contribution to journalArticle

24 Citations (Scopus)

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 €1700 resulting in an incremental cost-utility ratio (ICUR) of €8900 (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 €1700. MPs improve outcomes in a cost-effective manner, although they are not cost-saving on a lifetime horizon.

Original languageEnglish
Pages (from-to)1026-1032
Number of pages7
JournalEuropean Journal of Heart Failure
Volume10
Issue number10
DOIs
Publication statusPublished - 1 Oct 2008
Externally publishedYes

Keywords

  • Cost-effectiveness analysis
  • Hearth failure
  • Management programme
  • Markov model

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