title: [Cost effectiveness of bisoprolol in treatment of heart failure in Germany. An analysis based on the CIBIS-II study].
abstract: OBJECTIVE
  Economic analysis of bisoprolol plus standard therapy versus placebo plus standard therapy in the treatment of chronic heart failure in Germany.
  
  
  METHODS
  Prospective analysis of resource use and costs by way of integration into the international, randomized, double-blind CIBIS (Cardiac Insufficiency Bisoprolol Study)-II clinical trial, which treated 1,327 patients with bisoprolol and 1,320 with placebo. Two hundred and fifteen German patients were included in CIBIS-II (bisoprolol: 112, placebo: 103). The German health economic subpopulation comprised 97 patients (bisoprolol: 52, placebo: 45). The economic base analysis valued the resource use of every single patient of this subpopulation in monetary terms, from the perspective of Germany's third party payer (statutory sick funds).
  
  
  RESULTS
  Mean observation time was 1.3 years. During this time hospitalization costs of DM 783.--were saved in the bisoprolol group. Total direct medical costs amounted to DM 7,651.--in the bisoprolol group and DM 8,905.--in the placebo group. This means savings of DM 1,254.--per patient, or a 14.1% cost reduction. If mean data of all German CIBIS-II patients are used as a broader basis, bisoprolol therapy saves DM 1,203.--per patient. Bisoprolol therapy induced a mortality rate reduction from 17% to 12% in the overall clinical CIBIS-II population (n = 2,647). This difference is statistically highly significant (p < 0.0001). Altogether 74 lives could be saved by bisoprolol therapy. Saved life years amounted to 0.03 per patient after 65 weeks of therapy (460 days), and to 0.12 per patient after 130 weeks (30 months). As bisoprolol therapy leads to net savings, a formal cost-effectiveness analysis, which would relate incremental clinical efficiency to additional costs, is not needed.
  
  
  CONCLUSIONS
  The use of bisoprolol in the therapy of chronic heart failure is not only clinically effective, it also saves net costs.
authors.affiliation: Abteilung Medizinische Okonomie, Universitätsspital Zürich. thomas.szucs.@vdi.usz.ch
authors.forename: T D
authors.initials: TD
authors.lastname: Szucs
authors.forename: M
authors.initials: M
authors.lastname: Schwenkglenks
authors.forename: B
authors.initials: B
authors.lastname: Paschen
authors.forename: F
authors.initials: F
authors.lastname: Follath
mesh_terms: D000368:Aged; D017298:Bisoprolol / Q000191:economics* / Q000627:therapeutic use; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D004311:Double-Blind Method; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics*
chemical_list: D017298:Bisoprolol
vernacular_title: Wirtschaftlichkeit von Bisoprolol in der Behandlung der Herzinsuffizienz in Deutschland. Eine Analyse auf der Basis der CIBIS-II-Studie.