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Cost-effectiveness of spironolactone in patients with severe heart failure

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Abstract

Background Management of heart failure is estimated to consume between 1% and 2% of total healthcare resources with hospital admissions accounting for up to 70% of this. The ability of the aldosterone antagonist spironolactone to reduce hospital admission rates by 35% would be expected to prove cost-effective.

Aim To determine the cost-effectiveness of spironolactone when added to standard therapy in patients with severe chronic heart failure.

Methods A Markov model of chronic heart failure was constructed using Treeage® software. Irish cost data were incorporated into the model.

Results The incremental cost-effectiveness ratio (ICER) for spironolactone therapy was ¬466 per life year gained (LYG). Sensitivity analysis demonstrated an ICER range of ¬75 to ¬1,136 per LYG.

Conclusion This economic evaluation suggests that the addition of spironolactone to standard therapy for patients with severe chronic heart failure is not only safe and effective, but is highly cost-effective in the Irish healthcare setting.

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Authors and Affiliations

  1. National Centre for Pharmacoeconomics, St James’s Hospital, James’s Street, Dublin, Ireland

    L Tilson, B McGowan, M Ryan & M Barry

Authors
  1. L Tilson
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  2. B McGowan
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  3. M Ryan
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  4. M Barry
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Correspondence to M Barry.

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Tilson, L., McGowan, B., Ryan, M. et al. Cost-effectiveness of spironolactone in patients with severe heart failure. Ir J Med Sci 172, 70–72 (2003). https://doi.org/10.1007/BF02915250

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  • DOI: https://doi.org/10.1007/BF02915250

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