Cost-effectiveness of the treatment of heart failure with ramipril: a Spanish analysis of the AIRE study.
OBJECTIVE
To estimate the cost-effectiveness of adding ramipril to conventional treatment in patients with heart failure after myocardial infarction from the perspective of the Spanish National Health System.


RESULTS
A retrospective analysis of the AIRE study was made, using previously published data from the clinical trial combined with local Spanish resource and cost data. A typical rehospitalisation for a heart failure episode would last an average of 11.6 days with an average cost of 350.80 per day. The incremental cost of ramipril per life-year gained in the baseline case was 1550.10 after 3.8 years of follow-up. Sensitivity analysis showed that the basic conclusions were robust in spite of extreme variations in the values of the key parameters of the model.


CONCLUSIONS
The use of ramipril in addition to conventional treatment in heart failure patients after myocardial infarction is cost-effective both according to currently accepted international standards of what constitutes a cost-effective intervention and also indirectly by comparing the results with similar pharmaceutical products financed under the Spanish National Health System.
Hart
Warren Mark
WM
EcoStat Consulting Group, San Sebastián, Spain.
Rubio-Terres
Carlos
C
Pajuelo
Francisco
F
González Juanatey
Jose R
JR
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics; D009203:Myocardial Infarction / Q000188:drug therapy / Q000191:economics*; D010359:Patient Readmission / Q000191:economics; D017257:Ramipril / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D012189:Retrospective Studies; D013030:Spain
D000806:Angiotensin-Converting Enzyme Inhibitors; D017257:Ramipril