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Incremental effects of concurrent pharmacotherapeutic regimens for heart failure on hospitalizations and costs

Grant H Skrepnek1, Jacob Abarca, Daniel C Malone

  • 1College of Pharmacy, University of Arizona, Tucson, AZ 85721-0207, USA. skrepnek@pharmacy.arizona.edu

The Annals of Pharmacotherapy
|October 13, 2005
PubMed

Insights

Patients with heart failure (HF) on suboptimal medication regimens face higher hospitalization risks and costs. Optimal use of guideline-recommended HF medications significantly reduces these risks and associated healthcare expenses.

Area of Science:

  • Cardiology
  • Pharmacotherapy
  • Health Economics

Background:

  • Inappropriate medication use in heart failure (HF) patients complicates evidence-based care.
  • Suboptimal pharmacotherapy contributes to increased hospitalizations and healthcare costs.

Purpose of the Study:

  • To assess the impact of concurrent and persistent use of ACE inhibitors, beta-blockers, loop diuretics, and digoxin on HF patient outcomes.
  • To evaluate the one-year risk of all-cause hospitalization and total healthcare costs associated with HF treatment.

Main Methods:

  • Retrospective analysis of a US managed care organization database (1997-1999).
  • Multivariate regression models examined associations between treatment regimens, hospitalizations, and costs.
  • Controlled for patient demographics and risk factors.

Main Results:

  • Patients receiving none of the four studied HF agents had a 2.5-fold higher hospitalization risk and 43.6% greater costs.
  • Persistent use of three or more HF agents was associated with an 80% reduction in hospitalizations and a 70% decrease in costs.

Conclusions:

  • A significant number of HF patients receive suboptimal pharmacotherapy in real-world settings.
  • Suboptimal care leads to increased hospitalizations and healthcare expenditures.
  • Quality improvement programs are needed to ensure guideline-adherent HF treatment.
Abstract

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