PMID- 24610254
OWN - NLM
STAT- MEDLINE
DCOM- 20150126
LR  - 20211203
IS  - 1179-187X (Electronic)
IS  - 1175-3277 (Linking)
VI  - 14
IP  - 3
DP  - 2014 Jun
TI  - Cost effectiveness of eplerenone in patients with chronic heart failure.
PG  - 209-16
LID - 10.1007/s40256-014-0066-3 [doi]
AB  - BACKGROUND: Chronic heart failure (CHF) remains an important cause of morbidity 
      and mortality worldwide. Currently, there are no cost-effectiveness studies of 
      eplerenone use in patients with New York Heart Association (NYHA) class II CHF. 
      OBJECTIVE: We sought to evaluate the cost effectiveness of eplerenone compared 
      with placebo in patients with chronic systolic heart failure and NYHA class II 
      symptoms. METHODS AND RESULTS: A 10-year Markov model with yearly cycles was 
      constructed to evaluate the cost effectiveness of eplerenone compared with 
      placebo, based on data from the EMPHASIS-HF (Eplerenone in Mild Patients 
      Hospitalization And Survival Study in Heart Failure) study. The model classified 
      subjects into two health states: 'Alive with CHF' and 'Dead'. Information about 
      the cost of disease was derived from Australian Refined Diagnosis-Related Groups 
      (AR-DRG) data. The cost of eplerenone was taken from the Australian 
      Pharmaceutical Benefit Scheme. Utility data were derived from published sources, 
      and a 5 % annual discount rate was applied to future costs and benefits. Over 10 
      years, and compared with placebo, the model predicted that eplerenone would lead 
      to a saving of 0.5 life-years (discounted) and 0.4 quality-adjusted life-years 
      (QALYs) per person. The net cost was (in Australian dollars [$A]) $A6,117 
      (discounted) per person. These equated to incremental cost-effectiveness ratios 
      of $A12,024 per life-year saved and $A16,700 per QALY saved. Sensitivity analyses 
      indicated that these results were robust. CONCLUSION: Eplerenone may represent a 
      cost-effective strategy for preventing morbidity and mortality among patients 
      with chronic systolic heart failure and NYHA class II symptoms.
FAU - Ademi, Zanfina
AU  - Ademi Z
AD  - Department of Medicine (Royal Melbourne Hospital), Melbourne EpiCentre, 
      University of Melbourne, 7 East, Main Building, Grattan Street, Parkville, VIC, 
      3050, Australia, zademi@unimelb.edu.au.
FAU - Pasupathi, Kumar
AU  - Pasupathi K
FAU - Krum, Henry
AU  - Krum H
FAU - Liew, Danny
AU  - Liew D
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Am J Cardiovasc Drugs
JT  - American journal of cardiovascular drugs : drugs, devices, and other 
      interventions
JID - 100967755
RN  - 0 (Mineralocorticoid Receptor Antagonists)
RN  - 27O7W4T232 (Spironolactone)
RN  - 6995V82D0B (Eplerenone)
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Australia
MH  - Chronic Disease
MH  - Cost-Benefit Analysis
MH  - Eplerenone
MH  - Female
MH  - Heart Failure, Systolic/*drug therapy
MH  - Humans
MH  - Male
MH  - Markov Chains
MH  - Middle Aged
MH  - Mineralocorticoid Receptor Antagonists/*economics/*therapeutic use
MH  - Models, Economic
MH  - Quality-Adjusted Life Years
MH  - Racial Groups
MH  - Sex Factors
MH  - Spironolactone/*analogs & derivatives/economics/therapeutic use
EDAT- 2014/03/13 06:00
MHDA- 2015/01/27 06:00
CRDT- 2014/03/11 06:00
PHST- 2014/03/11 06:00 [entrez]
PHST- 2014/03/13 06:00 [pubmed]
PHST- 2015/01/27 06:00 [medline]
AID - 10.1007/s40256-014-0066-3 [doi]
PST - ppublish
SO  - Am J Cardiovasc Drugs. 2014 Jun;14(3):209-16. doi: 10.1007/s40256-014-0066-3.