Cost-effectiveness analysis of serial measurement of circulating natriuretic peptide concentration in chronic heart failure.
In: Heart, Jg. 99 (2013-02-15), Heft 4, S. 267-271
Online
academicJournal
Zugriff:
Objective To assess the cost-effectiveness of three monitoring strategies for optimising medical therapy in chronic heart failure (CHF). Design This analysis was based on six randomised controlled trials. Costs were measured from a UK NHS perspective and estimated for patients' lifetime. The health outcome was the quality-adjusted life-year (QALY). Setting Hospital and community Patients Patients with CHF. Interventions Serial measurement of natriuretic peptide (NP) by a specialist, clinical assessment by a specialist, and usual care in the community Main outcome measures Costs, QALYs, and incremental cost-effectiveness ratio (ICER). Results Serial NP measurement by a specialist was the most cost-effective option in patients with CHF due to left ventricular systolic dysfunction (LVSD), showing an ICER of £3304 compared with clinical assessment. Serial NP measurement by a specialist was strongly favoured in patients with CHF from any cause, for all patients (ICER of £14 694 compared with clinical assessment by a specialist) and for the age subgroup =75 years (ICER of £2517 compared with usual care). However, serial NP measurement by a specialist was dominated (less effective and more costly) by alternative strategies in the subgroup age >75 years with CHF from any cause. Clinical assessment by a specialist of patients >75 years of age with CHF from any cause was cost-effective compared with usual care (ICER of £11 508). Conclusions Serial measurement of NP concentration by a specialist is the most cost-effective strategy for CHF due to LVSD and from any cause, except in the subgroup of patients >75 years with CHF from any cause, where treatment guided by NP measurement may be harmful and not cost-effective. [ABSTRACT FROM AUTHOR]
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Cost-effectiveness analysis of serial measurement of circulating natriuretic peptide concentration in chronic heart failure.
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Autor/in / Beteiligte Person: | Laramée, Philippe ; Wonderling, David ; Swain, Sharon ; Al-Mohammad, Abdallah ; Mant, Jonathan |
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Zeitschrift: | Heart, Jg. 99 (2013-02-15), Heft 4, S. 267-271 |
Veröffentlichung: | 2013 |
Medientyp: | academicJournal |
ISSN: | 1355-6037 (print) |
DOI: | 10.1136/heartjnl-2012-302692 |
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