title: Comparison of the initial hospitalization costs between the patients treated with dobutamine and the patients treated with amrinone for acute decompensated heart failure in a Japanese institute.
abstract: OBJECTIVE
  Phosphodiesterase (PDE) III inhibitor therapy is effective for treatment of acute decompensated heart failure (ADHF). Nevertheless, this drug is expensive than conventional inotropic agent dobutamine. We compared total medication costs of the patients treated with PDE III inhibitor amrinone therapy to that of the patients treated with conventional dobutamine therapy during initial hospitalization.
  
  
  METHODS
  We analyzed 160 consecutive patients with ADHF admitted to our hospital. Shock, dehydration, severe infection, multiple organ failure, and mild heart failure (New York Heart Association class IIs) were not eligible for the study. Ninety-seven patients were divided into two groups: 1) DOB group treated with dobutamine therapy; and 2) AMR group treated with amrinone therapy. Total medication costs and cost for hospital room charge were calculated based on their usage during the initial hospitalization for each patient. Group comparison was done between the DOB and AMR groups.
  
  
  RESULTS
  Length of stay was longer in the DOB group than in the AMR group. Mean calculated cost of intravenous drugs was higher in the DOB group (173,186 +/- 239,147 yen) than in the AMR group (63,145 +/- 47,223 yen, P < 0.05). Total medication costs were higher in the DOB group than in the AMR group. Cost for hospital room charge was higher in the DOB group than in the AMR group.
  
  
  CONCLUSIONS
  In the treatment of ADHF, appropriate therapy even with expensive drugs makes total medication costs less expensive comparing with conventional therapy with cheaper drugs during initial hospitalization.
authors.affiliation: Department of Cardiovascular Dynamics, Research Institute, National Cardiovascular Center, Fujishirodai, Suita, Japan. kkoma@hsp.ncvc.go.jp
authors.forename: Kazuo
authors.initials: K
authors.lastname: Komamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsuo
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Sasaki
mesh_terms: D000368:Aged; D000676:Amrinone / Q000191:economics / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000191:economics / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D003362:Cost-Benefit Analysis; D004280:Dobutamine / Q000191:economics / Q000627:therapeutic use*; D016527:Drug Costs; D017850:Economics, Pharmaceutical; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D018709:Statistics, Nonparametric
chemical_list: D002316:Cardiotonic Agents; D004280:Dobutamine; D000676:Amrinone