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Economic implications of treatment guidelines for congestive heart failure.
Can J Cardiol. 2005 Dec; 21(14):1301-6.CJ

Abstract

Congestive heart failure (CHF) is the most common cause of cardiovascular hospital admission. A significant proportion of the costs of CHF is due to hospitalizations. The present study evaluated the economic impact of a modest increase in the use of angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, spironolactone and digoxin on CHF hospitalizations. Patients with CHF were identified through the Canadian Institute for Health Information (CIHI) database. The efficacy of ACE inhibitors, beta-blockers, spironolactone and digoxin in the first year of treatment were retrieved from the Survival and Ventricular Enlargement (SAVE) trial, a meta-analysis, the Randomized Aldactone Evaluation Study (RALES) and the Digitalis Investigation Group (DIG) trial, respectively. Cost of CHF hospitalization was based on the National List of Provincial Costs. Costs of drug treatment were based on the 2002 Alberta Health and Wellness Drug Benefit list. Physician visits for drug titration were also included in the model. A total of 85,679 patients with CHF were identified with a total of 106,130 hospital discharges. A 10% increase in use of ACE inhibitors, beta-blockers, spironolactone and digoxin would incur in a total cost due to avoidable hospital admissions of 0.4 million dollars, 1.3 million dollars, 3.7 million dollars and 1.2 million dollars, respectively. Similarly, the costs of drug treatment would be 2.2 million dollars, 1.3 million dollars, 0.3 million dollars and 0.5 million dollars, respectively. An increase in the use of the above medications would save 6.6 million dollars due to avoidable hospital admissions. The total cost of drug treatment was 4.3 million dollars, giving a net savings of 2.3 million dollars in the first year. The implementation of evidence-based therapy for CHF treatment is not only clinically efficacious, but also economically attractive.

Authors+Show Affiliations

University of Alberta, Edmonton.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16341301

Citation

Shibata, Marcelo C., et al. "Economic Implications of Treatment Guidelines for Congestive Heart Failure." The Canadian Journal of Cardiology, vol. 21, no. 14, 2005, pp. 1301-6.
Shibata MC, Nilsson C, Hervas-Malo M, et al. Economic implications of treatment guidelines for congestive heart failure. Can J Cardiol. 2005;21(14):1301-6.
Shibata, M. C., Nilsson, C., Hervas-Malo, M., Jacobs, P., & Tsuyuki, R. T. (2005). Economic implications of treatment guidelines for congestive heart failure. The Canadian Journal of Cardiology, 21(14), 1301-6.
Shibata MC, et al. Economic Implications of Treatment Guidelines for Congestive Heart Failure. Can J Cardiol. 2005;21(14):1301-6. PubMed PMID: 16341301.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Economic implications of treatment guidelines for congestive heart failure. AU - Shibata,Marcelo C, AU - Nilsson,Carolyn, AU - Hervas-Malo,Marilou, AU - Jacobs,Philip, AU - Tsuyuki,Ross T, PY - 2005/12/13/pubmed PY - 2006/2/25/medline PY - 2005/12/13/entrez SP - 1301 EP - 6 JF - The Canadian journal of cardiology JO - Can J Cardiol VL - 21 IS - 14 N2 - Congestive heart failure (CHF) is the most common cause of cardiovascular hospital admission. A significant proportion of the costs of CHF is due to hospitalizations. The present study evaluated the economic impact of a modest increase in the use of angiotensin-converting enzyme (ACE) inhibitors, beta-blockers, spironolactone and digoxin on CHF hospitalizations. Patients with CHF were identified through the Canadian Institute for Health Information (CIHI) database. The efficacy of ACE inhibitors, beta-blockers, spironolactone and digoxin in the first year of treatment were retrieved from the Survival and Ventricular Enlargement (SAVE) trial, a meta-analysis, the Randomized Aldactone Evaluation Study (RALES) and the Digitalis Investigation Group (DIG) trial, respectively. Cost of CHF hospitalization was based on the National List of Provincial Costs. Costs of drug treatment were based on the 2002 Alberta Health and Wellness Drug Benefit list. Physician visits for drug titration were also included in the model. A total of 85,679 patients with CHF were identified with a total of 106,130 hospital discharges. A 10% increase in use of ACE inhibitors, beta-blockers, spironolactone and digoxin would incur in a total cost due to avoidable hospital admissions of 0.4 million dollars, 1.3 million dollars, 3.7 million dollars and 1.2 million dollars, respectively. Similarly, the costs of drug treatment would be 2.2 million dollars, 1.3 million dollars, 0.3 million dollars and 0.5 million dollars, respectively. An increase in the use of the above medications would save 6.6 million dollars due to avoidable hospital admissions. The total cost of drug treatment was 4.3 million dollars, giving a net savings of 2.3 million dollars in the first year. The implementation of evidence-based therapy for CHF treatment is not only clinically efficacious, but also economically attractive. SN - 0828-282X UR - https://www.unboundmedicine.com/medline/citation/16341301/Economic_implications_of_treatment_guidelines_for_congestive_heart_failure_ L2 - https://medlineplus.gov/heartfailure.html DB - PRIME DP - Unbound Medicine ER -