Cost-effectiveness analysis of carvedilol for the treatment of chronic heart failure in Japan.
BACKGROUND
The cost-effectiveness of beta-blocker use in patients with chronic heart failure (CHF) has never been elucidated in a Japanese study.


RESULTS
A Markov model for outpatients with CHF was constructed to simulate remaining life expectancy and expected medical costs for each patient. Each patient was assumed that they received either carvedilol in addition to conventional therapies (ie, digitalis, diuretics, and angiotensin-converting enzyme inhibitors) or conventional therapies alone. Analyses were conducted both for each patient's remaining lifetime and for a period of 5 years. Analyses were performed from the perspective of Japanese healthcare insurance. Analysis for treatment over the course of each patient's expected life span with carvedilol plus conventional therapies versus conventional therapies alone yielded expected medical costs of 3.5 million yen and 5.5 million yen respectively, and a life expectancy of 121 months and 88 months, respectively. The analysis of a 5-year period yielded 1.4 million yen and 2.8 million yen in expected medical costs and 49 and 45 months life expectancy, respectively, for carvedilol versus conventional therapy.


CONCLUSIONS
Carvedilol treatment for CHF patients is a highly cost-effective method of therapy in the Japanese medical environment.
Inomata
Takayuki
T
Department of Internal Medicine and Cardiology, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan. inotaka@med.kitasato-u.ac.jp
Izumi
Tohru
T
Kobayashi
Makoto
M
D000319:Adrenergic beta-Antagonists / Q000191:economics* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000191:economics / Q000627:therapeutic use; D002227:Carbazoles / Q000191:economics* / Q000627:therapeutic use; D000077261:Carvedilol; D003362:Cost-Benefit Analysis; D004232:Diuretics / Q000191:economics / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D007564:Japan; D008390:Markov Chains; D008875:Middle Aged; D011412:Propanolamines / Q000191:economics* / Q000627:therapeutic use; D016019:Survival Analysis; D013997:Time Factors; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D002227:Carbazoles; D004232:Diuretics; D011412:Propanolamines; D000077261:Carvedilol