PMID- 29723595
OWN - NLM
STAT- MEDLINE
DCOM- 20190403
LR  - 20200613
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 24
IP  - 10
DP  - 2018 Oct
TI  - Cost-Effectiveness Benefits of a Disease Management Program:The REMADHE Trial 
      Results.
PG  - 627-637
LID - S1071-9164(18)30168-4 [pii]
LID - 10.1016/j.cardfail.2018.04.008 [doi]
AB  - BACKGROUND: Published studies have generated mixed, controversial results 
      regarding the cost-effectiveness of heart failure disease management programs 
      (HF-DMPs). This study assessed the cost-effectiveness of an HF-DMP in ambulatory 
      patients compared with usual care (UC). METHODS: In the prospective randomized 
      REMADHE trial, we evaluated incremental costs per quality-adjusted life-year 
      (QALY) and life-year (LY) gained as effectiveness ratios (ICERs) over a study 
      period of 2.47 +/- 1.75 years. RESULTS: The REMADHE HF-DMP was more effective and 
      less costly than UC in terms of both QALYs and LYs (95% and 55% chance of 
      dominance, respectively). Average saving was US$7345 (2.5%-97.5% bootstrapped 
      confidence interval -16,573 to +921). The chance of DMP being cost-effective at a 
      willingness to pay US$10,000 per QALY or LY was 99% and 96%, respectively. 
      Cost-effectiveness of HF-DMP was highest in subgroups with left ventricular 
      ejection fraction <35%, age >50 years, male sex, New York Heart Association 
      (NYHA) functional class >/=III, and ischemic etiology. The chance of DMP being 
      cost-effective at a willingness to pay US$10,000 per QALY was >/=90% in all 
      subgroups apart from NYHA functional class I-II, where it was 70%. Even when the 
      intervention costs increased by 500% or when excluding outliers in costs, DMP had 
      a high chance of being cost-effective (87%-99%). CONCLUSIONS: The HF-DMP of the 
      REMADHE trial, which encompasses long-term repeated education alongside telephone 
      monitoring, has a high probability of being cost-effective in ambulatory patients 
      with HF.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Bocchi, Edimar Alcides
AU  - Bocchi EA
AD  - Heart Institute (Incor) of Sao Paulo University Medical School (HCFUMSP), Sao 
      Paulo, Brazil. Electronic address: dcledimar@incor.usp.br.
FAU - da Cruz, FAtima das Dores
AU  - da Cruz FDD
AD  - Heart Institute (Incor) of Sao Paulo University Medical School (HCFUMSP), Sao 
      Paulo, Brazil.
FAU - BrandAo, Sara Michelly
AU  - BrandAo SM
AD  - Heart Institute (Incor) of Sao Paulo University Medical School (HCFUMSP), Sao 
      Paulo, Brazil.
FAU - Issa, Victor
AU  - Issa V
AD  - Heart Institute (Incor) of Sao Paulo University Medical School (HCFUMSP), Sao 
      Paulo, Brazil.
FAU - Ayub-Ferreira, Silvia Moreira
AU  - Ayub-Ferreira SM
AD  - Heart Institute (Incor) of Sao Paulo University Medical School (HCFUMSP), Sao 
      Paulo, Brazil.
FAU - Brunner la Rocca, Hans-Peter
AU  - Brunner la Rocca HP
AD  - Department of Cardiology, Maastricht University Medical Center, Cardiovascular 
      Research Institute Maastricht (CARIM), Maastricht, The Netherlands.
FAU - Wijk, Sandra Sanders-van
AU  - Wijk SS
AD  - Department of Cardiology, Maastricht University Medical Center, Cardiovascular 
      Research Institute Maastricht (CARIM), Maastricht, The Netherlands.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20180430
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
SB  - IM
CIN - J Card Fail. 2018 Oct;24(10):638-639. PMID: 30308240
MH  - Cost-Benefit Analysis
MH  - *Disease Management
MH  - Female
MH  - Follow-Up Studies
MH  - *Health Care Costs
MH  - Heart Failure/*economics/therapy
MH  - Humans
MH  - Male
MH  - *Program Evaluation
MH  - Prospective Studies
MH  - Time Factors
OTO - NOTNLM
OT  - Heart failure
OT  - cost
OT  - cost-effectiveness
OT  - disease management program
EDAT- 2018/05/04 06:00
MHDA- 2019/04/04 06:00
CRDT- 2018/05/04 06:00
PHST- 2017/06/27 00:00 [received]
PHST- 2018/04/16 00:00 [revised]
PHST- 2018/04/25 00:00 [accepted]
PHST- 2018/05/04 06:00 [pubmed]
PHST- 2019/04/04 06:00 [medline]
PHST- 2018/05/04 06:00 [entrez]
AID - S1071-9164(18)30168-4 [pii]
AID - 10.1016/j.cardfail.2018.04.008 [doi]
PST - ppublish
SO  - J Card Fail. 2018 Oct;24(10):627-637. doi: 10.1016/j.cardfail.2018.04.008. Epub 
      2018 Apr 30.