Cost effectiveness of bisoprolol in the treatment of chronic congestive heart failure in Sweden: analysis using data from the Cardiac Insufficiency Bisoprolol Study II trial.
OBJECTIVE
To investigate the cost effectiveness of adding the beta-blocker bisoprolol to standard treatment in patients with congestive heart failure (CHF).


METHODS
A cost-effectiveness study was based on the Cardiac Insufficiency Bisoprolol Study II (CIBIS-II), a randomised clinical trial investigating the efficacy of adding bisoprolol to standard therapy of CHF. The cost-effectiveness analysis was carried out from a societal perspective.


METHODS
Health effects were measured in terms of years of life gained. On the cost side, treatment costs for pharmaceuticals and hospitalisations were included. Data on healthcare resource consumption from CIBIS-II were used and were combined with average Swedish retail prices for medicines, and average costs for hospitalisations based on hospital admissions, in the base case. The costs of added years of life, i.e. consumption net of production during life-years gained were also included.


RESULTS
If costs of added years of life were not included, then bisoprolol therapy increased life expectancy at an incremental cost of Swedish kronor (SEK) 13 094 (1999 values) per year of life gained. If costs of added years of life were included, then the incremental cost-effectiveness ratio of bisoprolol therapy was SEK 168 858 per year of life gained.


CONCLUSIONS
For patients with CHF with the characteristics of those in CIBIS-II, the cost effectiveness of bisoprolol therapy compares favourably with that of other cardiovascular therapies.
Ekman
M
M
Department of Economics, Stockholm School of Economics, Sweden. mattias.ekman@hhs.se
Zethraeus
N
N
Jönsson
B
B
D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use*; D017298:Bisoprolol / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D017048:Health Care Costs; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D013548:Sweden
D000959:Antihypertensive Agents; D017298:Bisoprolol