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What is the economic value of digoxin therapy in congestive heart failure patients? Results from the DIG trial.
J Card Fail. 2006 Jun; 12(5):336-42.JC

Abstract

BACKGROUND

The Digitalis Investigation Group (DIG) clinical train randomized 6800 congestive heart failure patients (ejection fraction > or =45%) to a daily regimen of either digoxin or placebo. At 37 months average follow-up, patients in both groups had similar mortality. We determined the incremental costs associated with the use of digoxin in this high-risk population.

METHODS AND RESULTS

Hospitalizations and medical costs were compared by using a societal perspective. Hospitalizations were assigned Medicare DRG codes by using descriptive information from the clinical trial. Digoxin use was assigned a cost by using the 1998 average wholesale price as reported by Red Book. On average, there were fewer hospitalizations in digoxin-treated patients. These patients had lower heart failure yet higher non-heart failure hospitalization costs than placebo patients. Digoxin therapy was cost saving versus placebo in only 27% of 1000 bootstrap samples using Medicare costs (mean costs 12,648 dollars vs. 12,362 dollars) and in 44% of samples using commercial carrier costs (mean costs 17,400 dollars vs. 17,306 dollars). How ever, digoxin was cost saving in >50% of samples for several higher-risk patient subgroups.

CONCLUSIONS

The use of digoxin therapy versus placebo was associated with reduced hospitalizations. Moreover, the resulting cost-savings could cover the costs of this inexpensive therapy in selected subgroups of higher-risk patients. In the remainder, there is a modest cost associated with this therapy.

Authors+Show Affiliations

The Outcomes Research and Assessment Group, The Duke Clinical Research Institute, Durham, North Carolina 27715, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16762794

Citation

Eisenstein, Eric L., et al. "What Is the Economic Value of Digoxin Therapy in Congestive Heart Failure Patients? Results From the DIG Trial." Journal of Cardiac Failure, vol. 12, no. 5, 2006, pp. 336-42.
Eisenstein EL, Yusuf S, Bindal V, et al. What is the economic value of digoxin therapy in congestive heart failure patients? Results from the DIG trial. J Card Fail. 2006;12(5):336-42.
Eisenstein, E. L., Yusuf, S., Bindal, V., Bourassa, M. G., Horney, A., Collins, J. F., & Mark, D. B. (2006). What is the economic value of digoxin therapy in congestive heart failure patients? Results from the DIG trial. Journal of Cardiac Failure, 12(5), 336-42.
Eisenstein EL, et al. What Is the Economic Value of Digoxin Therapy in Congestive Heart Failure Patients? Results From the DIG Trial. J Card Fail. 2006;12(5):336-42. PubMed PMID: 16762794.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What is the economic value of digoxin therapy in congestive heart failure patients? Results from the DIG trial. AU - Eisenstein,Eric L, AU - Yusuf,Salim, AU - Bindal,Vishal, AU - Bourassa,Martial G, AU - Horney,Anne, AU - Collins,Joseph F, AU - Mark,Daniel B, AU - ,, PY - 2004/12/09/received PY - 2006/04/18/revised PY - 2006/04/18/accepted PY - 2006/6/10/pubmed PY - 2006/9/22/medline PY - 2006/6/10/entrez SP - 336 EP - 42 JF - Journal of cardiac failure JO - J. Card. Fail. VL - 12 IS - 5 N2 - BACKGROUND: The Digitalis Investigation Group (DIG) clinical train randomized 6800 congestive heart failure patients (ejection fraction > or =45%) to a daily regimen of either digoxin or placebo. At 37 months average follow-up, patients in both groups had similar mortality. We determined the incremental costs associated with the use of digoxin in this high-risk population. METHODS AND RESULTS: Hospitalizations and medical costs were compared by using a societal perspective. Hospitalizations were assigned Medicare DRG codes by using descriptive information from the clinical trial. Digoxin use was assigned a cost by using the 1998 average wholesale price as reported by Red Book. On average, there were fewer hospitalizations in digoxin-treated patients. These patients had lower heart failure yet higher non-heart failure hospitalization costs than placebo patients. Digoxin therapy was cost saving versus placebo in only 27% of 1000 bootstrap samples using Medicare costs (mean costs 12,648 dollars vs. 12,362 dollars) and in 44% of samples using commercial carrier costs (mean costs 17,400 dollars vs. 17,306 dollars). How ever, digoxin was cost saving in >50% of samples for several higher-risk patient subgroups. CONCLUSIONS: The use of digoxin therapy versus placebo was associated with reduced hospitalizations. Moreover, the resulting cost-savings could cover the costs of this inexpensive therapy in selected subgroups of higher-risk patients. In the remainder, there is a modest cost associated with this therapy. SN - 1532-8414 UR - https://www.unboundmedicine.com/medline/citation/16762794/What_is_the_economic_value_of_digoxin_therapy_in_congestive_heart_failure_patients_Results_from_the_DIG_trial_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1071-9164(06)00211-9 DB - PRIME DP - Unbound Medicine ER -