Decision-analytic evaluation of the clinical effectiveness and cost-effectiveness of management programmes in chronic heart failure

Alexander Göhler, Annette Conrads-Frank, Stewart S. Worrell, Benjamin P. Geisler, Elkan F. Halpern, Rainer Dietz, Stefan D. Anker, G. Scott Gazelle, Uwe Siebert

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Background and aims: While management programmes (MPs) for chronic heart failure (CHF) are clinically effective, their cost-effectiveness remains uncertain. Thus, this study sought to determine the cost-effectiveness of MPs. Methods and results: We developed a Markov model to estimate life expectancy, quality-adjusted life expectancy, lifetime costs, and the incremental cost-effectiveness of MPs as compared to standard care. Standard care was defined by the EuroHeart Failure Survey for Germany, MP efficacy was derived from our recent meta-analysis and cost estimates were based on the German healthcare system. For a population with a mean age 67 years (35% female) at onset of CHF, our model predicted an average quality-adjusted life expectancy of 2.64 years for standard care and 2.83 years for MP. MP yielded additional lifetime costs of €1700 resulting in an incremental cost-utility ratio (ICUR) of €8900 (95% CI: dominant to 177,100) per quality-adjusted life year (QALY) gained. Sensitivity analyses demonstrated that the ICUR was sensitive to age and sex. Conclusion: MPs increase life expectancy in patients with CHF by an average of 84 days and increase lifetime cost of care by approximately €1700. MPs improve outcomes in a cost-effective manner, although they are not cost-saving on a lifetime horizon.

Original languageEnglish
Pages (from-to)1026-1032
Number of pages7
JournalEuropean Journal of Heart Failure
Volume10
Issue number10
DOIs
Publication statusPublished - Oct 2008

Fingerprint

Cost-Benefit Analysis
Heart Failure
Costs and Cost Analysis
Life Expectancy
Quality of Life
Quality-Adjusted Life Years
Standard of Care
Germany
Meta-Analysis
Delivery of Health Care
Population

Keywords

  • Cost-effectiveness analysis
  • Hearth failure
  • Management programme
  • Markov model

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Decision-analytic evaluation of the clinical effectiveness and cost-effectiveness of management programmes in chronic heart failure. / Göhler, Alexander; Conrads-Frank, Annette; Worrell, Stewart S.; Geisler, Benjamin P.; Halpern, Elkan F.; Dietz, Rainer; Anker, Stefan D.; Gazelle, G. Scott; Siebert, Uwe.

In: European Journal of Heart Failure, Vol. 10, No. 10, 10.2008, p. 1026-1032.

Research output: Contribution to journalArticle

Göhler, A, Conrads-Frank, A, Worrell, SS, Geisler, BP, Halpern, EF, Dietz, R, Anker, SD, Gazelle, GS & Siebert, U 2008, 'Decision-analytic evaluation of the clinical effectiveness and cost-effectiveness of management programmes in chronic heart failure', European Journal of Heart Failure, vol. 10, no. 10, pp. 1026-1032. https://doi.org/10.1016/j.ejheart.2008.07.018
Göhler, Alexander ; Conrads-Frank, Annette ; Worrell, Stewart S. ; Geisler, Benjamin P. ; Halpern, Elkan F. ; Dietz, Rainer ; Anker, Stefan D. ; Gazelle, G. Scott ; Siebert, Uwe. / Decision-analytic evaluation of the clinical effectiveness and cost-effectiveness of management programmes in chronic heart failure. In: European Journal of Heart Failure. 2008 ; Vol. 10, No. 10. pp. 1026-1032.
@article{8ca369ed3bd14d7e9bf00b653af4b224,
title = "Decision-analytic evaluation of the clinical effectiveness and cost-effectiveness of management programmes in chronic heart failure",
abstract = "Background and aims: While management programmes (MPs) for chronic heart failure (CHF) are clinically effective, their cost-effectiveness remains uncertain. Thus, this study sought to determine the cost-effectiveness of MPs. Methods and results: We developed a Markov model to estimate life expectancy, quality-adjusted life expectancy, lifetime costs, and the incremental cost-effectiveness of MPs as compared to standard care. Standard care was defined by the EuroHeart Failure Survey for Germany, MP efficacy was derived from our recent meta-analysis and cost estimates were based on the German healthcare system. For a population with a mean age 67 years (35{\%} female) at onset of CHF, our model predicted an average quality-adjusted life expectancy of 2.64 years for standard care and 2.83 years for MP. MP yielded additional lifetime costs of €1700 resulting in an incremental cost-utility ratio (ICUR) of €8900 (95{\%} CI: dominant to 177,100) per quality-adjusted life year (QALY) gained. Sensitivity analyses demonstrated that the ICUR was sensitive to age and sex. Conclusion: MPs increase life expectancy in patients with CHF by an average of 84 days and increase lifetime cost of care by approximately €1700. MPs improve outcomes in a cost-effective manner, although they are not cost-saving on a lifetime horizon.",
keywords = "Cost-effectiveness analysis, Hearth failure, Management programme, Markov model",
author = "Alexander G{\"o}hler and Annette Conrads-Frank and Worrell, {Stewart S.} and Geisler, {Benjamin P.} and Halpern, {Elkan F.} and Rainer Dietz and Anker, {Stefan D.} and Gazelle, {G. Scott} and Uwe Siebert",
year = "2008",
month = "10",
doi = "10.1016/j.ejheart.2008.07.018",
language = "English",
volume = "10",
pages = "1026--1032",
journal = "European Journal of Heart Failure",
issn = "1388-9842",
publisher = "John Wiley & Sons, Ltd",
number = "10",

}

TY - JOUR

T1 - Decision-analytic evaluation of the clinical effectiveness and cost-effectiveness of management programmes in chronic heart failure

AU - Göhler, Alexander

AU - Conrads-Frank, Annette

AU - Worrell, Stewart S.

AU - Geisler, Benjamin P.

AU - Halpern, Elkan F.

AU - Dietz, Rainer

AU - Anker, Stefan D.

AU - Gazelle, G. Scott

AU - Siebert, Uwe

PY - 2008/10

Y1 - 2008/10

N2 - Background and aims: While management programmes (MPs) for chronic heart failure (CHF) are clinically effective, their cost-effectiveness remains uncertain. Thus, this study sought to determine the cost-effectiveness of MPs. Methods and results: We developed a Markov model to estimate life expectancy, quality-adjusted life expectancy, lifetime costs, and the incremental cost-effectiveness of MPs as compared to standard care. Standard care was defined by the EuroHeart Failure Survey for Germany, MP efficacy was derived from our recent meta-analysis and cost estimates were based on the German healthcare system. For a population with a mean age 67 years (35% female) at onset of CHF, our model predicted an average quality-adjusted life expectancy of 2.64 years for standard care and 2.83 years for MP. MP yielded additional lifetime costs of €1700 resulting in an incremental cost-utility ratio (ICUR) of €8900 (95% CI: dominant to 177,100) per quality-adjusted life year (QALY) gained. Sensitivity analyses demonstrated that the ICUR was sensitive to age and sex. Conclusion: MPs increase life expectancy in patients with CHF by an average of 84 days and increase lifetime cost of care by approximately €1700. MPs improve outcomes in a cost-effective manner, although they are not cost-saving on a lifetime horizon.

AB - Background and aims: While management programmes (MPs) for chronic heart failure (CHF) are clinically effective, their cost-effectiveness remains uncertain. Thus, this study sought to determine the cost-effectiveness of MPs. Methods and results: We developed a Markov model to estimate life expectancy, quality-adjusted life expectancy, lifetime costs, and the incremental cost-effectiveness of MPs as compared to standard care. Standard care was defined by the EuroHeart Failure Survey for Germany, MP efficacy was derived from our recent meta-analysis and cost estimates were based on the German healthcare system. For a population with a mean age 67 years (35% female) at onset of CHF, our model predicted an average quality-adjusted life expectancy of 2.64 years for standard care and 2.83 years for MP. MP yielded additional lifetime costs of €1700 resulting in an incremental cost-utility ratio (ICUR) of €8900 (95% CI: dominant to 177,100) per quality-adjusted life year (QALY) gained. Sensitivity analyses demonstrated that the ICUR was sensitive to age and sex. Conclusion: MPs increase life expectancy in patients with CHF by an average of 84 days and increase lifetime cost of care by approximately €1700. MPs improve outcomes in a cost-effective manner, although they are not cost-saving on a lifetime horizon.

KW - Cost-effectiveness analysis

KW - Hearth failure

KW - Management programme

KW - Markov model

UR - http://www.scopus.com/inward/record.url?scp=53249107184&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=53249107184&partnerID=8YFLogxK

U2 - 10.1016/j.ejheart.2008.07.018

DO - 10.1016/j.ejheart.2008.07.018

M3 - Article

C2 - 18760666

AN - SCOPUS:53249107184

VL - 10

SP - 1026

EP - 1032

JO - European Journal of Heart Failure

JF - European Journal of Heart Failure

SN - 1388-9842

IS - 10

ER -