Valutazione economica della terapia con lisinopril ad alto verso basso dosaggio nel trattamento dei soggetti con scompenso cardiaco cronico
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Economic evaluation of high vs low dosage lisinopril in patients with chronic heart failure
To compare the economic consequences of treating chronic heart failure (CHF) with high versus low dosage lisinopril.
A cost-effectiveness analysis compared cost and effects of lisinopril 32.5–35 versus 2.5–5 mg/die in the perspective of the Italian National Health Service (NHS). Effects and resources absorption were derived from the ATLAS results. Pharmacological costs were quantified according to the Italian market price of the drug; hospitalisation costs were quantified on the basis of DRG tariffs. Effects are expressed as reduction of cardiovascular morbidity and mortality and life-years saved (LYS). For both costs and effects a 5% annual discount was applied.
CHF patients in an hypothetical Italian setting, according to the ATLAS design.
Patients and participants
More than 3000 patients with NYHA classes II to IV, CHF and left ventricular ejection fractions equal or less than 0.30.
Main outcome measures and results
Clinical effects of treating 1000 patients for 3.58 years with high versus low dosage lisinopril would correspond to a saving of € 99.300. The therapy with high dosage of lisinopril dominates the alternative with the low dosage of the drug.
Treating CHF patients with high dosage of lisinopril is not only more effective but also less costly than with low dosage of the drug. The incremental pharmacological costs are offset by savings in hospitalisations costs.
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