title: Cost effectiveness of eplerenone in patients with chronic heart failure.
abstract: BACKGROUND
  Chronic heart failure (CHF) remains an important cause of morbidity and mortality worldwide. Currently, there are no cost-effectiveness studies of eplerenone use in patients with New York Heart Association (NYHA) class II CHF.
  
  
  OBJECTIVE
  We sought to evaluate the cost effectiveness of eplerenone compared with placebo in patients with chronic systolic heart failure and NYHA class II symptoms.
  
  
  RESULTS
  A 10-year Markov model with yearly cycles was constructed to evaluate the cost effectiveness of eplerenone compared with placebo, based on data from the EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization And Survival Study in Heart Failure) study. The model classified subjects into two health states: 'Alive with CHF' and 'Dead'. Information about the cost of disease was derived from Australian Refined Diagnosis-Related Groups (AR-DRG) data. The cost of eplerenone was taken from the Australian Pharmaceutical Benefit Scheme. Utility data were derived from published sources, and a 5 % annual discount rate was applied to future costs and benefits. Over 10 years, and compared with placebo, the model predicted that eplerenone would lead to a saving of 0.5 life-years (discounted) and 0.4 quality-adjusted life-years (QALYs) per person. The net cost was (in Australian dollars [$A]) $A6,117 (discounted) per person. These equated to incremental cost-effectiveness ratios of $A12,024 per life-year saved and $A16,700 per QALY saved. Sensitivity analyses indicated that these results were robust.
  
  
  CONCLUSIONS
  Eplerenone may represent a cost-effective strategy for preventing morbidity and mortality among patients with chronic systolic heart failure and NYHA class II symptoms.
authors.affiliation: Department of Medicine (Royal Melbourne Hospital), Melbourne EpiCentre, University of Melbourne, 7 East, Main Building, Grattan Street, Parkville, VIC, 3050, Australia, zademi@unimelb.edu.au.
authors.forename: Zanfina
authors.initials: Z
authors.lastname: Ademi
authors.forename: Kumar
authors.initials: K
authors.lastname: Pasupathi
authors.forename: Henry
authors.initials: H
authors.lastname: Krum
authors.forename: Danny
authors.initials: D
authors.lastname: Liew
mesh_terms: D000367:Age Factors; D000368:Aged; D001315:Australia; D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D000077545:Eplerenone; D005260:Female; D054143:Heart Failure, Systolic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D000451:Mineralocorticoid Receptor Antagonists / Q000191:economics* / Q000627:therapeutic use*; D018803:Models, Economic; D019057:Quality-Adjusted Life Years; D044469:Racial Groups; D012737:Sex Factors; D013148:Spironolactone / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013148:Spironolactone; D000077545:Eplerenone