11774
document
Intravenous levosimendan treatment is cost-effective compared with dobutamine in severe low-output heart failure : an analysis based on the international LIDO trial . BACKGROUND Levosimendan , a novel calcium sensitiser , improves cardiac performance and symptoms without increasing oxygen consumption , and decreases the mortality of patients with low-output heart failure . AIMS To estimate the cost-effectiveness of intravenous treatment with levosimendan compared with dobutamine in patients with severe low-output heart failure . METHODS This economic evaluation was based on a European clinical trial ( LIDO ) , in which 203 patients with severe heart failure randomly received a 24 h infusion with either levosimendan or dobutamine . Survival and resource utilisation data were collected for 6 months ; survival was extrapolated assuming a mean additional lifetime of 3 years based on data from the Cooperative North Scandinavian Enalapril Survival Study trial . Costs were based on study drug usage and hospitalisation in the 6-month follow-up . A sensitivity analysis on dosage of drug and duration of survival was performed . RESULTS The mean survival over 6 months was 157+/-52 days in the levosimendan group and 139+/-64 days in the dobutamine group ( P < 0.01 ) . When extrapolated up to 3 years , the gain in life expectancy was estimated at 0.35 years ( discounted at 3 % ) . Levosimendan increased the mean cost per patient by 1108 , which was entirely due to the cost of the study drug . The incremental cost per life-year saved ( LYS ) was 3205 at the European level ; in the individual countries the cost per LYS ranged between 3091 and 3331 . The result was robust in the sensitivity analysis . CONCLUSIONS Although the patients in the levosimendan group were alive for more days and thus at risk of hospitalisation for longer , there was no increase in hospitalisation or hospitalisation costs with levosimendan treatment . The cost per LYS using levosimendan compares favourably with other cost-effectiveness analyses in cardiology .
11775
Intervention_Pharmacological
levosimendan
11776
Intervention_Pharmacological
dobutamine
11777
Intervention_Pharmacological
Levosimendan
11778
Intervention_Pharmacological
levosimendan
11779
Intervention_Pharmacological
dobutamine
11780
Intervention_Pharmacological
levosimendan
11781
Intervention_Pharmacological
dobutamine
11782
Intervention_Pharmacological
levosimendan
11783
Intervention_Pharmacological
dobutamine
11784
Intervention_Pharmacological
Levosimendan
11785
Intervention_Pharmacological
levosimendan
11786
Intervention_Pharmacological
levosimendan
11787
Outcome_Physical
dosage of drug
11788
Outcome_Mortality
duration of survival
11789
Outcome_Mortality
mean survival over 6 months
11790
Outcome_Mortality
gain in life expectancy
11791
Outcome_Other
mean cost per patient
11792
Outcome_Other
incremental cost per life-year
11793
Outcome_Other
risk of hospitalisation
11794
Outcome_Other
hospitalisation or hospitalisation costs
11795
Outcome_Other
cost-effectiveness analyses
11796
Participant_Condition
severe low-output heart failure
11797
Participant_Sample-size
203