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Economic impact of intermittent intravenous outpatient treatment with levosimendan in patients with advanced heart failure

Session Acute heart failure: how to improve survival

Speaker Nicolas Manito Lorite

Event : Heart Failure 2018

  • Topic : heart failure
  • Sub-topic : Pharmacotherapy
  • Session type : Rapid Fire Abstracts

Authors : J Comin-Colet (Barcelona,ES), N Manito (Barcelona,ES), C Enjuanes (Barcelona,ES), J Gonzalez-Costello (Barcelona,ES), C Campo (Madrid,ES), D Rubio-Rodriguez (Madrid,ES), C Rubio-Terres (Madrid,ES)

Authors:
J Comin-Colet1 , N Manito1 , C Enjuanes1 , J Gonzalez-Costello1 , C Campo2 , D Rubio-Rodriguez3 , C Rubio-Terres3 , 1University Hospital of Bellvitge, Cardiology Dpt. - Barcelona - Spain , 2Orion Spain, Medical Dpt - Madrid - Spain , 3Health Value, , Health Economics and Outcomes Research Consulting - Madrid - Spain ,

On behalf: LION-HEART Investigators

Topic(s):
Acute Heart Failure: Pharmacotherapy

Background:

The LION-HEART study was a multicentre, double-blind, randomised, parallel-group, placebo-controlled trial evaluating the efficacy and safety of intravenous administration of intermittent doses of levosimendan in outpatients with advanced chronic heart failure. In this study, a lower rate of hospitalization for heart failure (HF) was observed in patients treated with levosimendan (22,9%) than in untreated patients (66,7%).

Purpose:

Perform a cost analysis to determine whether the lower rate of hospitalizations for HF with levosimendan could generate savings for the Spanish National Health System (NHS), compared to the option of not treating patients with advanced HF.

Methods:

An economic model that included hospitalization rates from the LION-HEART study, HF hospitalization costs and acquisition and intravenous administration costs of levosimendan was performed. The time horizon of the analysis was 12 months. Two analyzes were carried out, one deterministic and the other probabilistic (second-order Monte Carlo simulation).

Results:

According to the deterministic analysis, the total saving for each patient treated with levosimendan would amount to €1,093.30. The additional cost of the medication (€1,404.61) and its intravenous administration (€480.24) was more than compensated by the savings due to the lower rate of hospitalization with levosimendan (€2,978.16). In the probabilistic analysis, the saving per patient treated with levosimendan would be €1,162.43 (95% CI €286.47; €2,599.65). The probability of savings with levosimendan compared to the no treatment option would be 94.1%.

Conclusion:

Intermittent outpatient treatment with levosimendan could generate savings for the Spanish NHS, compared to the option of not treating patients with advanced HF.

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