Abstract
In this study, we examine the cost effectiveness of carvedilol for the treatment of
chronic heart failure (CHF). We use a Markov model to project life expectancy and
lifetime medical care costs for a hypothetical cohort of patients with CHF who were
assumed alternatively to receive carvedilol plus conventional therapy (digoxin, diuretics,
and angiotensin-converting enzyme inhibitors) or conventional therapy alone. Patients
on carvedilol were assumed to experience a reduced risk of death and hospitalization
for CHF, which is consistent with findings from the US Carvedilol Heart Failure Trials
Program. The benefits of carvedilol were projected under 2 alternative scenarios.
In the first (“limited benefits”), benefits were conservatively assumed to persist
for 6 months, the average duration of follow-up in these clinical trials, and then
end abruptly. In the other (“extended benefits”), they were arbitrarily assumed to
persist for 6 months and then decline gradually over time, vanishing by the end of
3 years. We estimated our model using data from the US Carvedilol Heart Failure Trials
Program and other sources. For patients receiving conventional therapy alone, estimated
life expectancy was 6.67 years; corresponding figures for those also receiving carvedilol
were 6.98 and 7.62 years under the limited and extended benefits scenarios, respectively.
Expected lifetime costs of CHF-related care were estimated to be $28,756 for conventional
therapy, and $36,420 and $38,867 for carvedilol (limited and extended benefits, respectively).
Cost per life-year saved for carvedilol was $29,477 and $12,799 under limited and
extended benefits assumptions, respectively. The cost effectiveness of carvedilol
for CHF compares favorably to that of other generally accepted medical interventions,
even under conservative assumptions regarding the duration of therapeutic benefit.
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Article info
Publication history
Published online: August 16, 2004
Accepted:
November 3,
1998
Received in revised form:
November 3,
1998
Received:
May 27,
1998
Footnotes
☆This study was supported by SmithKline Beecham Pharmaceuticals, Collegeville, Pennsylvania, which markets carvedilol under the brand name Coreg.
Identification
Copyright
© 1999 Excerpta Medica Inc. Published by Elsevier Inc. All rights reserved.
