Cost-effectiveness of spironolactone in patients with severe heart failure.
BACKGROUND
Management of heart failure is estimated to consume between 1% and 2% of total healthcare resources with hospital admissions accounting for up to 70% of this. The ability of the aldosterone antagonist spironolactone to reduce hospital admission rates by 35% would be expected to prove cost-effective.


OBJECTIVE
To determine the cost-effectiveness of spironolactone when added to standard therapy in patients with severe chronic heart failure.


METHODS
A Markov model of chronic heart failure was constructed using Treeage software. Irish cost data were incorporated into the model.


RESULTS
The incremental cost-effectiveness ratio (ICER) for spironolactone therapy was Euro 466 per life year gained (LYG). Sensitivity analysis demonstrated an ICER range of Euro 75 to Euro 1,136 per LYG.


CONCLUSIONS
This economic evaluation suggests that the addition of spironolactone to standard therapy for patients with severe chronic heart failure is not only safe and effective, but is highly cost-effective in the Irish healthcare setting.
Tilson
L
L
National Centre for Pharmacoeconomics, St James's Hospital, Dublin, Ireland.
McGowan
B
B
Ryan
M
M
Barry
M
M
D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D008390:Markov Chains; D000451:Mineralocorticoid Receptor Antagonists / Q000191:economics* / Q000627:therapeutic use*; D013148:Spironolactone / Q000191:economics* / Q000627:therapeutic use*
D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone