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Study Finds Heart Failure Medications Highly Cost-Effective

Authors see potential savings for health care system (Mar. 28)

A new study conducted at the University of California, Los Angeles has found that heart failure medications recommended by national guidelines are highly cost-effective in saving lives and may provide savings to the health care system. Currently online, the study will be published in the April 2 print issue of the Journal of the American College of Cardiology.

The researchers studied the incremental health and cost benefits of three common heart-failure medications that are recommended by national guidelines developed by organizations such as the American College of Cardiology and the American Heart Association.

“We found that use of one or more of these key medications in combination was associated with significant health gains while at the same time being cost-effective or providing a cost savings,” said senior author Dr. Gregg Fonarow. “Our findings demonstrate the importance of prescribing these national guideline–directed medical therapies to patients with heart failure.”

The study focused on patients with mild-to-moderate chronic heart failure who had weakening function in the heart’s left ventricle and symptoms of heart failure, which occurs when the ventricle can no longer pump enough blood to the body’s other organs. With the heart’s diminishing function, fluid can build up in the lungs, so most patients take a diuretic.

The researchers used a statistical model to assess the specific incremental and cumulative health- and cost-benefit contributions of three medications, compared with diuretics alone, in the treatment of patients with heart failure. The medications studied included angiotensin-converting enzyme (ACE) inhibitors, aldosterone antagonists, and beta blockers.

The investigators found that treatment with one or a combination of these medications was associated with lower costs and higher quality of life when compared with receiving a diuretic alone. The greatest gain in quality-adjusted life years (QALYs) for patients was achieved when all three guideline-directed medications were provided.

The team calculated different scenarios and found that the incremental cost-effectiveness ratio of adding each medication was less than $1,500 for each QALY. In some scenarios, the medications were actually cost-saving, where heart failure patients’ lives were prolonged at lower costs to the health care system.

The study found that up to $14,000 could be spent over a lifetime on a heart failure disease-management program to improve medication adherence and still be highly cost-effective.

Fonarow noted that the costs of not effectively taking these key medications would be higher because of increased hospitalizations and the need for other interventions.

“Given the high health-care value provided by these medical therapies for heart failure, reducing patient costs for these medications or even providing a financial incentive to promote adherence is likely to be advantageous to patients as well as to the health care system,” Fonarow said.

Source: UCLA Health System; March 28, 2013.

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