PMID- 18793034
OWN - NLM
STAT- MEDLINE
DCOM- 20081211
LR  - 20211020
IS  - 1170-7690 (Print)
IS  - 1170-7690 (Linking)
VI  - 26
IP  - 10
DP  - 2008
TI  - Long-term cost-effectiveness analysis of nebivolol compared with standard care in 
      elderly patients with heart failure: an individual patient-based simulation 
      model.
PG  - 879-89
AB  - BACKGROUND AND OBJECTIVE: The SENIORS trial demonstrated that nebivolol is 
      effective in the treatment of heart failure in elderly patients (e.g. > or = 70 
      years). This analysis evaluates the cost effectiveness of nebivolol compared with 
      standard treatment. METHODS: An individual patient-simulation model based on a 
      Markov modelling framework was developed to compare costs and outcomes for 
      nebivolol and standard care in patients with heart failure starting treatment at 
      the age of 70 years. Health states were defined by New York Heart Association 
      (NYHA) class and death. At a given NYHA class and a given cycle, patients could 
      die, be hospitalized for cardiovascular disease or remain stable. Risks for these 
      events were derived from individual patient data from the SENIORS trial. The risk 
      of each event in a given cycle was based on the subject's baseline 
      characteristics and time in the current health state. The economic analysis was 
      conducted from the UK NHS perspective with a lifetime horizon. The costs (euro; 
      year 2006 values) considered were drug costs for nebivolol and other cardiac 
      drugs, costs of GP visits, outpatient specialist visits and 
      cardiovascular-related hospitalizations. Univariate and probabilistic sensitivity 
      analysis was conducted. RESULTS: In the baseline analysis, the total cost per 
      patient was euro6740 and euro9288, and QALYs were 5.194 and 5.843 for patients 
      aged 70 years at the start of treatment for the standard treatment and nebivolol 
      groups, respectively. The probabilistic sensitivity analysis provided an 
      incremental cost-effectiveness ratio of euro3926 (95% CI 3731, 4159) per QALY. 
      CONCLUSIONS: This analysis indicates that nebivolol appears to be a 
      cost-effective treatment for elderly patients with heart failure compared with 
      standard care.
FAU - Yao, Guiqing
AU  - Yao G
AD  - University of Birmingham, Birmingham, UK.
FAU - Freemantle, Nick
AU  - Freemantle N
FAU - Flather, Marcus
AU  - Flather M
FAU - Tharmanathan, Puvan
AU  - Tharmanathan P
FAU - Coats, Andrew
AU  - Coats A
FAU - Poole-Wilson, Philip A
AU  - Poole-Wilson PA
CN  - SENIORS Investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Pharmacoeconomics
JT  - PharmacoEconomics
JID - 9212404
RN  - 0 (Adrenergic beta-Antagonists)
RN  - 0 (Benzopyrans)
RN  - 0 (Ethanolamines)
RN  - 030Y90569U (Nebivolol)
MH  - Adrenergic beta-Antagonists/economics/*therapeutic use
MH  - Aged
MH  - Aged, 80 and over
MH  - Benzopyrans/economics/*therapeutic use
MH  - Computer Simulation
MH  - Cost-Benefit Analysis
MH  - Ethanolamines/economics/*therapeutic use
MH  - Female
MH  - Health Care Costs/statistics & numerical data
MH  - Heart Failure/*drug therapy/economics
MH  - Humans
MH  - Male
MH  - Markov Chains
MH  - *Models, Economic
MH  - Nebivolol
MH  - Quality-Adjusted Life Years
MH  - Randomized Controlled Trials as Topic
MH  - United Kingdom
EDAT- 2008/09/17 09:00
MHDA- 2008/12/17 09:00
CRDT- 2008/09/17 09:00
PHST- 2008/09/17 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/09/17 09:00 [entrez]
AID - 26107 [pii]
AID - 10.2165/00019053-200826100-00007 [doi]
PST - ppublish
SO  - Pharmacoeconomics. 2008;26(10):879-89. doi: 10.2165/00019053-200826100-00007.