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A cost minimisation analysis of cardiac failure treatment in the UK using CIBIS trial data. Cardiac Insufficiency
M Malek1, J Cunningham-Davis, L Malek
1PharmacoEconomics Research Centre, University of St Andrews, Scotland.
Insights
Beta-blocker bisoprolol, when added to standard heart failure treatment, significantly reduces hospital admissions. This cost-minimisation analysis indicates that bisoprolol is at least cost-neutral for the UK National Health Service.
Area of Science:
- Pharmacoeconomics
- Cardiology
- Health Services Research
Background:
- Clinical benefits of beta-blockers for heart failure are debated.
- Economic impact of beta-blockade remains largely unexplored.
- Cardiac Insufficiency Bisoprolol Study (CIBIS) showed reduced hospital admissions but not mortality.
Purpose of the Study:
- To conduct a cost-minimisation analysis of bisoprolol in heart failure patients in the UK.
- To evaluate the economic impact of adjuvant bisoprolol therapy on direct healthcare costs.
Main Methods:
- Cost minimisation analysis using data from the CIBIS trial.
- Focus on direct costs: bisoprolol medication and inpatient heart failure treatment.
- Sensitivity analyses performed on all cost driver parameters.
Main Results:
- Adjuvant bisoprolol therapy is at least cost-neutral compared to standard therapy alone.
- Additional drug costs of bisoprolol are offset by reduced inpatient treatment costs.
- Analysis considered UK-specific costs.
Conclusions:
- Adjuvant bisoprolol therapy represents a cost-effective strategy for managing heart failure in the UK.
- The economic benefits, alongside potential non-quantifiable clinical improvements, support its use.
- This study provides economic justification for beta-blocker use in heart failure management.
Abstract:
The clinical benefits of beta-blockers in heart failure are currently subject to intense debate and are being investigated. The economic impact of beta-blockade, however, has largely remained unexplored. The Cardiac Insufficiency Bisoprolol Study (CIBIS), while failing to show statistically significant reduction in mortality over conventional therapy, demonstrates that the administration of bisoprolol adjuvant to standard therapy leads to a significant reduction in hospital admission. The present study is a cost minimisation analysis based on CIBIS data for the UK and is restricted to direct costs only. The costs of bisoprolol medication and inpatient treatment of heart failure are considered. The 'base case' analysis and the sensitivity analyses carried on all cost driver parameters show that administering bisoprolol to heart failure patients adjuvantly to the standard therapy is at least cost neutral. Additional drug costs incurred by bisoprolol are compensated by the inpatient treatment costs of heart failure avoided. All other non-quantifiable clinical benefits such as improvement of New York Heart Association functional class are positive extras to patients and the National Health Service.