title: Economic evaluation of levosimendan versus dobutamine for the treatment of acute heart failure in Italy.
abstract: BACKGROUND
  Inodilators are the first-choice class of drugs for the treatment of acute heart failure (AHF). Levosimendan is a relatively recent inodilatory agent, presenting superior outcomes in comparison with traditional inotropes.
  
  
  METHODS
  An economic evaluation of levosimendan for the treatment of AHF in Italy was performed. In a retrospective study conducted on patients with AHF admitted to a teaching hospital in Rome, two groups were derived from an observational registry: 147 patients treated with levosimendan and 145 treated with dobutamine. Follow-up was at 1 year after treatment. In the reference study looked at in this paper, treatment with levosimendan reduced mean length of stay (LOS) by 1.5 days (P<0.05). Reduction in the rehospitalization rate was 6.7% (P<0.05). Mortality rate at 1 month was reduced by 4.8% (P<0.05).
  
  
  RESULTS
  Based on the reference study, a cost analysis from the hospital perspective was carried out. The incremental cost of treatment with levosimendan (€697) was equivalent to the incremental savings (€694), the latter being obtained from the reduction in LOS (€508) and rehospitalization rate (€186).
  
  
  CONCLUSIONS
  Despite the limitations of this study, and even neglecting all nonmonetary health gains as additional outcomes, levosimendan appears to be a competitive alternative compared with dobutamine for the treatment of AHF in the Italian hospital setting.
authors.affiliation: Springer Healthcare, via Lanino 5, 20144, Milano, Italy. carlo.lucioni@springer.com
authors.forename: Carlo
authors.initials: C
authors.lastname: Lucioni
authors.forename: Alessandra
authors.initials: A
authors.lastname: D'Ambrosi
authors.forename: Silvio
authors.initials: S
authors.lastname: Mazzi
authors.forename: Piero
authors.initials: P
authors.lastname: Pollesello
authors.forename: Marjo
authors.initials: M
authors.lastname: Apajasalo
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
mesh_terms: D002316:Cardiotonic Agents / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D004280:Dobutamine / Q000191:economics* / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D006835:Hydrazones / Q000191:economics* / Q000627:therapeutic use*; D011724:Pyridazines / Q000191:economics* / Q000627:therapeutic use*; D012189:Retrospective Studies; D012384:Rome; D000077464:Simendan; D016896:Treatment Outcome
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan; D004280:Dobutamine