title: Cost-effectiveness of levosimendan in patients with acute heart failure.
abstract: Heart failure is a major public health problem because of its high prevalence and impact on mortality, morbidity, quality of life, and social costs. The aim of this analysis was to estimate the effects of the novel inodilator levosimendan versus standard inotropic therapy (ST) of dobutamine in acute heart failure. A study population of 292 patients with acute heart failure was derived from an observational registry of patients referred to our department. Of these, 147 patients received iv levosimendan (0.05-0.1 μg·kg·min for 24 hours), and 145 patients were treated with ST. Duration of hospitalization, survival at 1 month, and the rehospitalization rate during the year after the index hospitalization were evaluated. Cost-effectiveness analysis was performed. The mean length of hospitalization was 12.08 and 13.57 days in the levosimendan and ST groups, respectively (P < 0.05). Rehospitalization rates were lower in the levosimendan group at 6 months (1.44% vs. 2.3%; P < 0.05) and 12 months (7.6% vs. 14.3%; P < 0.05). Mortality rate at 1 month was 2.1% versus 6.9% in the levosimendan and ST groups, respectively (P < 0.05). The per-capita cost of treatment with levosimendan was €78.86 higher than that with ST during the first hospitalization but €280.22 lower when the rehospitalization rate was considered.
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrologic, and Geriatric Sciences, La Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico, Rome, Italy. francesco.fedele@uniroma1.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
authors.forename: Alessandra
authors.initials: A
authors.lastname: D'Ambrosi
authors.forename: Noemi
authors.initials: N
authors.lastname: Bruno
authors.forename: Carmen
authors.initials: C
authors.lastname: Caira
authors.forename: Bruno
authors.initials: B
authors.lastname: Brasolin
authors.forename: Massimo
authors.initials: M
authors.lastname: Mancone
mesh_terms: D000208:Acute Disease; D000368:Aged; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004280:Dobutamine / Q000191:economics / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D006835:Hydrazones / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data; D011724:Pyridazines / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077464:Simendan; D015996:Survival Rate
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004280:Dobutamine