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Long-term cost-effectiveness analysis of nebivolol compared with standard care in elderly patients with heart failure an individual patient-based simulation model

Long-term cost-effectiveness analysis of nebivolol compared with standard care in elderly patients with heart failure an individual patient-based simulation model
Long-term cost-effectiveness analysis of nebivolol compared with standard care in elderly patients with heart failure an individual patient-based simulation model
Background and objective: The SENIORS trial demonstrated that nebivolol is effective in the treatment of heart failure in elderly patients (e.g. ?70 years). This analysis evaluates the cost effectiveness of nebivolol compared with standard treatment.

Methods: An individual patient-simulation model based on a Markov modelling framework was developed to compare costs and outcomes for nebivolol and standard care in patients with heart failure starting treatment at the age of 70 years. Health states were defined by New York Heart Association (NYHA) class and death. At a given NYHA class and a given cycle, patients could die, be hospitalized for cardiovascular disease or remain stable. Risks for these events were derived from individual patient data from the SENIORS trial. The risk of each event in a given cycle was based on the subject’s baseline characteristics and time in the current health state.

The economic analysis was conducted from the UK NHS perspective with a lifetime horizon. The costs (€; year 2006 values) considered were drug costs for nebivolol and other cardiac drugs, costs of GP visits, outpatient specialist visits and cardiovascular-related hospitalizations. Univariate and probabilistic sensitivity analysis was conducted.

Results: In the baseline analysis, the total cost per patient was €6740 and €9288, and QALYs were 5.194 and 5.843 for patients aged 70 years at the start of treatment for the standard treatment and nebivolol groups, respectively. The probabilistic sensitivity analysis provided an incremental cost-effectiveness ratio of €3926 (95% CI 3731, 4159) per QALY.

Conclusions: This analysis indicates that nebivolol appears to be a cost-effective treatment for elderly patients with heart failure compared with standard care.
1170-7690
879-889
Yao, Guiqing
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Freemantle, N.
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Flather, M.
fd8e1f8e-7242-4c8b-a0c5-1f03a0b32569
Tharmanathan, P.
cafb96bb-7226-4c8a-8fd0-903a50ca75c0
Coats, A.
6dde9ce0-2e6c-4bd1-956b-7b8df6f837c9
Poole-Wilson, P.A.
57540334-a555-4cc0-95d3-8ff4bca94042
Yao, Guiqing
d777f84c-cf3d-4fad-bbc1-ea01dec01695
Freemantle, N.
76c59b7f-991b-4b1b-9ecc-c1ba3e282fb5
Flather, M.
fd8e1f8e-7242-4c8b-a0c5-1f03a0b32569
Tharmanathan, P.
cafb96bb-7226-4c8a-8fd0-903a50ca75c0
Coats, A.
6dde9ce0-2e6c-4bd1-956b-7b8df6f837c9
Poole-Wilson, P.A.
57540334-a555-4cc0-95d3-8ff4bca94042

Yao, Guiqing, Freemantle, N., Flather, M., Tharmanathan, P., Coats, A. and Poole-Wilson, P.A. (2008) Long-term cost-effectiveness analysis of nebivolol compared with standard care in elderly patients with heart failure an individual patient-based simulation model. PharmacoEconomics, 26 (10), 879-889. (doi:10.2165/00019053-200826100-00007).

Record type: Article

Abstract

Background and objective: The SENIORS trial demonstrated that nebivolol is effective in the treatment of heart failure in elderly patients (e.g. ?70 years). This analysis evaluates the cost effectiveness of nebivolol compared with standard treatment.

Methods: An individual patient-simulation model based on a Markov modelling framework was developed to compare costs and outcomes for nebivolol and standard care in patients with heart failure starting treatment at the age of 70 years. Health states were defined by New York Heart Association (NYHA) class and death. At a given NYHA class and a given cycle, patients could die, be hospitalized for cardiovascular disease or remain stable. Risks for these events were derived from individual patient data from the SENIORS trial. The risk of each event in a given cycle was based on the subject’s baseline characteristics and time in the current health state.

The economic analysis was conducted from the UK NHS perspective with a lifetime horizon. The costs (€; year 2006 values) considered were drug costs for nebivolol and other cardiac drugs, costs of GP visits, outpatient specialist visits and cardiovascular-related hospitalizations. Univariate and probabilistic sensitivity analysis was conducted.

Results: In the baseline analysis, the total cost per patient was €6740 and €9288, and QALYs were 5.194 and 5.843 for patients aged 70 years at the start of treatment for the standard treatment and nebivolol groups, respectively. The probabilistic sensitivity analysis provided an incremental cost-effectiveness ratio of €3926 (95% CI 3731, 4159) per QALY.

Conclusions: This analysis indicates that nebivolol appears to be a cost-effective treatment for elderly patients with heart failure compared with standard care.

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More information

Published date: October 2008
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 352884
URI: http://eprints.soton.ac.uk/id/eprint/352884
ISSN: 1170-7690
PURE UUID: 317e4043-8cff-4961-ad3d-e49abea77f4d

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Date deposited: 22 May 2013 13:11
Last modified: 14 Mar 2024 13:57

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Contributors

Author: Guiqing Yao
Author: N. Freemantle
Author: M. Flather
Author: P. Tharmanathan
Author: A. Coats
Author: P.A. Poole-Wilson

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