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 w...
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| Veröffentlicht in: | European journal of heart failure 2003-01, Vol.5 (1), p.101-108 |
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| container_title | European journal of heart failure |
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| creator | Cleland, J.G.F. Takala, A. Apajasalo, M. Zethraeus, N. Kobelt, G. |
| description | 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 |
| doi_str_mv | 10.1016/S1388-9842(02)00246-5 |
| format | Article |
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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.</description><identifier>ISSN: 1388-9842</identifier><identifier>EISSN: 1879-0844</identifier><identifier>DOI: 10.1016/S1388-9842(02)00246-5</identifier><identifier>PMID: 12559222</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Aged ; Cardiac Output, Low - drug therapy ; Cardiac Output, Low - economics ; Cardiac Output, Low - epidemiology ; Cardiotonic Agents - economics ; Cardiotonic Agents - therapeutic use ; Cost-Benefit Analysis - economics ; cost-effectiveness ; dobutamine ; Dobutamine - economics ; Dobutamine - therapeutic use ; Double-Blind Method ; Europe - epidemiology ; Female ; Follow-Up Studies ; heart failure ; Heart Failure - drug therapy ; Heart Failure - economics ; Heart Failure - epidemiology ; Humans ; Hydrazones - economics ; Hydrazones - therapeutic use ; Infusions, Intravenous ; Length of Stay - economics ; levosimendan ; LIDO trial ; Life Expectancy ; Male ; Middle Aged ; Patient Admission - economics ; Pyridazines - economics ; Pyridazines - therapeutic use ; Randomized Controlled Trials as Topic ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; Simendan ; Survival Analysis ; Treatment Outcome</subject><ispartof>European journal of heart failure, 2003-01, Vol.5 (1), p.101-108</ispartof><rights>Published on behalf of the European Society of Cardiology. All rights reserved. © 2003 the Authors</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4455-4b8a04269bebef827ac27a9596e542562f31050bf86be7cf53234f1587ec075f3</citedby><cites>FETCH-LOGICAL-c4455-4b8a04269bebef827ac27a9596e542562f31050bf86be7cf53234f1587ec075f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1016%2FS1388-9842%2802%2900246-5$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1016%2FS1388-9842%2802%2900246-5$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,777,781,1412,1428,27905,27906,45555,45556,46390,46814</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12559222$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cleland, J.G.F.</creatorcontrib><creatorcontrib>Takala, A.</creatorcontrib><creatorcontrib>Apajasalo, M.</creatorcontrib><creatorcontrib>Zethraeus, N.</creatorcontrib><creatorcontrib>Kobelt, G.</creatorcontrib><title>Intravenous levosimendan treatment is cost-effective compared with dobutamine in severe low-output heart failure: an analysis based on the international LIDO trial</title><title>European journal of heart failure</title><addtitle>European Journal of Heart Failure</addtitle><description>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.</description><subject>Aged</subject><subject>Cardiac Output, Low - drug therapy</subject><subject>Cardiac Output, Low - economics</subject><subject>Cardiac Output, Low - epidemiology</subject><subject>Cardiotonic Agents - economics</subject><subject>Cardiotonic Agents - therapeutic use</subject><subject>Cost-Benefit Analysis - economics</subject><subject>cost-effectiveness</subject><subject>dobutamine</subject><subject>Dobutamine - economics</subject><subject>Dobutamine - therapeutic use</subject><subject>Double-Blind Method</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>heart failure</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - economics</subject><subject>Heart Failure - epidemiology</subject><subject>Humans</subject><subject>Hydrazones - economics</subject><subject>Hydrazones - therapeutic use</subject><subject>Infusions, Intravenous</subject><subject>Length of Stay - economics</subject><subject>levosimendan</subject><subject>LIDO trial</subject><subject>Life Expectancy</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Patient Admission - economics</subject><subject>Pyridazines - economics</subject><subject>Pyridazines - therapeutic use</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Risk Factors</subject><subject>Sensitivity and Specificity</subject><subject>Severity of Illness Index</subject><subject>Simendan</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>1388-9842</issn><issn>1879-0844</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkdFuFCEUhifGxtbqI2i4MnoxFhiYYbww0dptt1ltjBoTbwgze8iiDKzA7LrP44vKdFd7awLhEP7_O-T8RfGE4JcEk_rsE6mEKFvB6HNMX2BMWV3ye8UJEU1bYsHY_Vz_lRwXD2P8jjFpsvBBcUwo5y2l9KT4PXcpqA04P0ZkYeOjGcAtlUMpgEq5TshE1PuYStAa-mQ2kK_DWgVYoq1JK7T03ZjUYBwg41CEDQRA1m9LP6b1mNAKVEhIK2PHAK9QZiun7C5mbqdipvjcbTWZEwSnkvH5GS3m727yJ4yyj4ojrWyEx4fztPgyu_h8flUubi7n528WZc8Y5yXrhMKM1m0HHWhBG9Xn3fK2Bs4or6muCOa406LuoOk1r2jFNOGigR43XFenxbM9dx38zxFikoOJPVirHOTxyIa2grYVz0K-F_bBxxhAy3Uwgwo7SbCc0pG36chp9BLnNaUjJ9_TQ4OxG2B55zrEkQWv94KtsbD7P6q8uL6a3XUo9wATE_z6B1Dhh6ybquHy64dL-ZEx8f4tnslv1R82oq-J</recordid><startdate>200301</startdate><enddate>200301</enddate><creator>Cleland, J.G.F.</creator><creator>Takala, A.</creator><creator>Apajasalo, M.</creator><creator>Zethraeus, N.</creator><creator>Kobelt, G.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200301</creationdate><title>Intravenous levosimendan treatment is cost-effective compared with dobutamine in severe low-output heart failure: an analysis based on the international LIDO trial</title><author>Cleland, J.G.F. ; Takala, A. ; Apajasalo, M. ; Zethraeus, N. ; Kobelt, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4455-4b8a04269bebef827ac27a9596e542562f31050bf86be7cf53234f1587ec075f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Aged</topic><topic>Cardiac Output, Low - drug therapy</topic><topic>Cardiac Output, Low - economics</topic><topic>Cardiac Output, Low - epidemiology</topic><topic>Cardiotonic Agents - economics</topic><topic>Cardiotonic Agents - therapeutic use</topic><topic>Cost-Benefit Analysis - economics</topic><topic>cost-effectiveness</topic><topic>dobutamine</topic><topic>Dobutamine - economics</topic><topic>Dobutamine - therapeutic use</topic><topic>Double-Blind Method</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>heart failure</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - economics</topic><topic>Heart Failure - epidemiology</topic><topic>Humans</topic><topic>Hydrazones - economics</topic><topic>Hydrazones - therapeutic use</topic><topic>Infusions, Intravenous</topic><topic>Length of Stay - economics</topic><topic>levosimendan</topic><topic>LIDO trial</topic><topic>Life Expectancy</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Patient Admission - economics</topic><topic>Pyridazines - economics</topic><topic>Pyridazines - therapeutic use</topic><topic>Randomized Controlled Trials as Topic</topic><topic>Risk Factors</topic><topic>Sensitivity and Specificity</topic><topic>Severity of Illness Index</topic><topic>Simendan</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cleland, J.G.F.</creatorcontrib><creatorcontrib>Takala, A.</creatorcontrib><creatorcontrib>Apajasalo, M.</creatorcontrib><creatorcontrib>Zethraeus, N.</creatorcontrib><creatorcontrib>Kobelt, G.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of heart failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cleland, J.G.F.</au><au>Takala, A.</au><au>Apajasalo, M.</au><au>Zethraeus, N.</au><au>Kobelt, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Intravenous levosimendan treatment is cost-effective compared with dobutamine in severe low-output heart failure: an analysis based on the international LIDO trial</atitle><jtitle>European journal of heart failure</jtitle><addtitle>European Journal of Heart Failure</addtitle><date>2003-01</date><risdate>2003</risdate><volume>5</volume><issue>1</issue><spage>101</spage><epage>108</epage><pages>101-108</pages><issn>1388-9842</issn><eissn>1879-0844</eissn><abstract>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.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>12559222</pmid><doi>10.1016/S1388-9842(02)00246-5</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1388-9842 |
| ispartof | European journal of heart failure, 2003-01, Vol.5 (1), p.101-108 |
| issn | 1388-9842 1879-0844 |
| language | eng |
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| subjects | Aged Cardiac Output, Low - drug therapy Cardiac Output, Low - economics Cardiac Output, Low - epidemiology Cardiotonic Agents - economics Cardiotonic Agents - therapeutic use Cost-Benefit Analysis - economics cost-effectiveness dobutamine Dobutamine - economics Dobutamine - therapeutic use Double-Blind Method Europe - epidemiology Female Follow-Up Studies heart failure Heart Failure - drug therapy Heart Failure - economics Heart Failure - epidemiology Humans Hydrazones - economics Hydrazones - therapeutic use Infusions, Intravenous Length of Stay - economics levosimendan LIDO trial Life Expectancy Male Middle Aged Patient Admission - economics Pyridazines - economics Pyridazines - therapeutic use Randomized Controlled Trials as Topic Risk Factors Sensitivity and Specificity Severity of Illness Index Simendan Survival Analysis Treatment Outcome |
| title | Intravenous levosimendan treatment is cost-effective compared with dobutamine in severe low-output heart failure: an analysis based on the international LIDO trial |
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