Cost-effectiveness analysis of the treatment with enalapril of chronic heart failure in Spain

The aim of this study is to analyse in terms of cost-effectiveness the utilisation of enalapril as part of chronic heart failure therapy in Spain. A computer spread sheet based upon the results of the treatment arm of the SOLVD (Studies on Left Ventricular Dysfunction) study was used, with costs and epidemiologic data referred to Spain. Epidemiologic data are extrapolations from either studies performed in other countries or estimates from hospital and outpatient clinics utilisation, and economic data are taken from Spanish studies. The time horizon of the study was set at four years, and results are referred to year 1993. Widespread use of enalapril increases survival in 1.7 months per individual or in 5-10,000 years for the whole population. It generates net savings for the health system estimated in 1,500 to 3,000 million pesetas, also in four years. Using enalapril as part of the standard therapy for chronic heart failure generates an increase both in saved years of life and quality of life, and is associated with net savings for the health system.