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