Economic impact of ramipril on hospitalization of high-risk cardiovascular patients.
OBJECTIVE
To estimate differences in direct costs attributable to avoided hospitalizations and procedures during the years of the HOPE (Heart Outcomes Prevention Evaluation) study after the cost of treatment with ramipril or alternative angiotensin-converting enzyme inhibitor therapy was taken into account.


METHODS
A decision analytical model was developed to estimate the economic impact of reductions in hospitalizations and/or procedures both at annual increments and over the first 4 years of the HOPE study. The analysis compared the number of cardiovascular events per endpoint per year in the intervention and placebo group with hospitalization and procedural costs. Cost data were derived from the literature and inflated to the appropriate index year using the consumer price index.


RESULTS
For approximately 9000 patients studied, the gross estimated savings in direct costs for 297 events avoided were more than $5 million over 4 years. After the cost of treatment was deducted for both groups, the net estimated savings were $871 000 over 4 years.


CONCLUSIONS
The results demonstrate that the use of ramipril provides cost-effective treatment for high-risk cardiovascular patients with an ejection fraction >40%.
Carroll
Cathryn A
CA
Division of Pharmacy Practice, University of Missouri, Kansas City, MO 64110, USA. carrollc@umkc.edu
Coen
Michael M
MM
Piepho
Robert W
RW
D015906:Angioplasty, Balloon, Coronary / Q000191:economics; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000191:economics* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000191:economics*; D001026:Coronary Artery Bypass / Q000191:economics; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003661:Decision Support Techniques; D006333:Heart Failure / Q000191:economics; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000191:economics; D017257:Ramipril / Q000191:economics* / Q000627:therapeutic use; D012307:Risk Factors; D020521:Stroke / Q000191:economics
D000806:Angiotensin-Converting Enzyme Inhibitors; D017257:Ramipril