title: Pharmaco-economics of levosimendan in cardiology: a European perspective.
abstract: BACKGROUND
  Heart failure places a significant economic burden on health care. Acute heart failure requires hospitalization and often frequent re-hospitalization in expensive wards where vasoactive rescue therapy is often added on top of standard medications. In these lean times, there is a growing need for cost-effective therapeutic options that supply superior support and in addition shorten the length of stay in hospital and reduce re-hospitalization rates. The inodilator levosimendan represents the latest addition to the vasoactive treatments of acute heart failure patients, and it appears to meet these expectations. Our aim was to answer the question whether the treatment efficacy of levosimendan - when selected as therapy for patients hospitalized for acute heart failure - brings savings to hospitals in various European countries representing different economies.
  
  
  RESULTS
  We took a conservative approach and selected some a fortiori arguments to simplify the calculations. We selected seven European countries to represent different economies: Italy, Spain, Greece, Germany, Sweden, Finland and Israel. Data on the costs of medications and on the cost per day were collected and fed in a simple algorithm to detect savings. These saving varied from country to country, from a minimum of €0.50 in Germany to a maximum of €354.64 in Sweden.
  
  
  CONCLUSIONS
  The use of levosimendan as a therapy for patients hospitalized for acute heart failure provides a net saving to hospitals driven by a reduction in the length of hospital stay. This finding is true in each of the countries considered in this study.
authors.affiliation: Helsinki University Central Hospital, Helsinki, Finland. Electronic address: markku.nieminen@hus.fi.
authors.forename: M S
authors.initials: MS
authors.lastname: Nieminen
authors.affiliation: Kardiologie, Angiologie und Internistische Intensivmedizin, St. Marien-Krankenhaus, Siegen, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Buerke
authors.affiliation: Second University Cardiology Clinic, Attiko Teaching Hospital, Athens, Greece.
authors.forename: J
authors.initials: J
authors.lastname: Parissis
authors.affiliation: Heart Failure Unit and Heart Transplant Clinic, Rabin Medical Center, Petah Tikva, Israel.
authors.forename: T
authors.initials: T
authors.lastname: Ben-Gal
authors.affiliation: Critical Care Proprietary Products Division, Orion Pharma, Espoo, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Pollesello
authors.affiliation: Critical Care Proprietary Products Division, Orion Pharma, Espoo, Finland.
authors.forename: M
authors.initials: M
authors.lastname: Kivikko
authors.affiliation: Heart Failure Clinic & Echo Lab, Gennimatas General Hospital of Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Karavidas
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, 'Sapienza' University of Rome, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Severino
authors.affiliation: IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Comín-Colet
authors.affiliation: Institute of Medical Sciences, Uppsala University, Akademiska sjukhuset, Uppsala, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Wikström
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrology, Anesthesiology and Geriatric Sciences, 'Sapienza' University of Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Fedele
mesh_terms: D000208:Acute Disease; D000465:Algorithms; D002309:Cardiology; D002316:Cardiotonic Agents / Q000191:economics* / Q000494:pharmacology*; D003362:Cost-Benefit Analysis; D017850:Economics, Pharmaceutical; D005060:Europe / Q000453:epidemiology; D006333:Heart Failure / Q000188:drug therapy* / Q000191:economics / Q000401:mortality; D006760:Hospitalization / Q000191:economics; D006801:Humans; D006835:Hydrazones / Q000191:economics* / Q000494:pharmacology*; D007902:Length of Stay / Q000191:economics; D018803:Models, Economic; D009026:Mortality; D011724:Pyridazines / Q000191:economics* / Q000494:pharmacology*; D011788:Quality of Life; D000077464:Simendan
chemical_list: D002316:Cardiotonic Agents; D006835:Hydrazones; D011724:Pyridazines; D000077464:Simendan
keywords: Acute heart failure; Benefits; Costs; Hospitalization; Inodilators; Length of stay