title: Cost-effectiveness of highly purified omega-3 polyunsaturated fatty acid ethyl esters in the treatment of chronic heart failure: results of Markov modelling in a UK setting.
abstract: OBJECTIVE
  A recent randomized placebo-controlled clinical trial has reported reductions in mortality and hospitalizations in patients with chronic heart failure (CHF) who were prescribed highly purified omega-3 polyunsaturated fatty acid ethyl esters (n-3 PUFA). This study aimed at evaluating the cost and benefits associated with their use in the treatment of CHF in a UK setting.
  
  
  RESULTS
  Results from a recent clinical trial were used to develop a Markov model to project clinical outcomes while capturing relevant costs and patient quality of life. The model captured outcomes over a lifetime horizon from a UK National Health Service perspective, with direct costs accounted in 2009 GBP (£) and discounted at 3.5% together with clinical benefits. Results are presented in terms of life expectancy, quality-adjusted life expectancy, direct costs, and incremental cost-effectiveness ratios. In addition to standard therapy, n-3 PUFA vs. placebo increased lifetime direct costs by £993 (≈€1150), with additional quality-adjusted life expectancy of 0.079 quality-adjusted life years (QALYs), and mean lifetime costs of £12,636 (≈€14,600) per QALY gained. Probabilistic sensitivity analyses suggested a 60% likelihood of n-3 PUFA being regarded as cost-effective versus placebo at a willingness-to-pay threshold of £30,000 (≈€34,600) per QALY gained.
  
  
  CONCLUSIONS
  By currently accepted standards of value for money in the UK; the addition of n-3 PUFA to optimal medical therapy for patients with heart failure is likely to be cost-effective.
authors.affiliation: National Heart & Lung Institute, Imperial College, Royal Brompton Hospital, London, UK. m.cowie@imperial.ac.uk
authors.forename: Martin R
authors.initials: MR
authors.lastname: Cowie
authors.forename: Sandrine
authors.initials: S
authors.lastname: Cure
authors.forename: Florence
authors.initials: F
authors.lastname: Bianic
authors.forename: Alistair
authors.initials: A
authors.lastname: McGuire
authors.forename: Gordon
authors.initials: G
authors.lastname: Goodall
authors.forename: Luigi
authors.initials: L
authors.lastname: Tavazzi
mesh_terms: D000368:Aged; D002908:Chronic Disease; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D008297:Male; D019057:Quality-Adjusted Life Years; D012680:Sensitivity and Specificity; D013222:State Medicine; D016896:Treatment Outcome; D006113:United Kingdom
chemical_list: D015525:Fatty Acids, Omega-3