Use of valsartan for the treatment of heart-failure patients not receiving ACE inhibitors: a budget impact analysis.
BACKGROUND
Heart failure is a widespread and costly malady. It represents the leading single diagnosis for hospitalized patients. For many heart failure patients, angiotensin-converting enzyme (ACE) inhibitors are either not tolerated or contraindicated, but angiotensin receptor blockers such as valsartan may be a therapeutic option for them.


OBJECTIVE
The aim of this study was to prepare a budget impact analysis to assist health plans in evaluating the financial impact of adding valsartan therapy to usual care for heart failure patients not receiving ACE inhibitors.


METHODS
A budget impact analysis was developed for a hypothetical US health plan. Model inputs included demographic data, estimates of the prevalence of heart failure and proportion of heart-failure patients not on ACE inhibitors, prevalence of heart failure-related hospitalization, cost data, and resultant health care utilization from the Valsartan Heart Failure Trial (Val-HeFT). Costs and cost savings were reported as year-2001 US dollars.


RESULTS
An estimated 1207 of hypothetical 250,000 enrollees were projected to have heart-failure diagnoses, with 603 (50.0%) not receiving ACE inhibitors, and 160 (26.5%) of such patients being hospitalized each year. For valsartan-treated patients, savings due to reduced hospitalizations and shorter length of hospital stay were 1,083,938 US dollars and 221,364 US dollars, respectively. Subtracting the cost of valsartan treatment (629,472 US dollars) from savings yielded projected net savings of 675,830 US dollars per year. Varying patient, treatment, and payer-mix characteristics resulted in projected net savings of $409,598 to 1,350,617 US dollars per year.


CONCLUSIONS
Addition of valsartan therapy to usual care in this model analysis resulted in net cost savings among hypothetical heart-failure patients not receiving ACE inhibitors. Substantial cost savings were realized, regardless of variation in model parameters.
Smith
Dean G
DG
Department of Health Management and Policy, University of Michigan, Ann Arbor, 48109, USA. deans@umich.edu
Cerulli
Annamaria
A
Frech
Feride H
FH
D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000191:economics / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000191:economics / Q000627:therapeutic use*; D002017:Budgets / Q000379:methods / Q000639:trends; D003362:Cost-Benefit Analysis; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D018803:Models, Economic; D013777:Tetrazoles / Q000191:economics / Q000627:therapeutic use*; D013997:Time Factors; D014633:Valine / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D000068756:Valsartan
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D013777:Tetrazoles; D000068756:Valsartan; D014633:Valine