title: Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure.
abstract: BACKGROUND
  Heart failure disease management programs can influence medical resource use and quality-adjusted survival. Because projecting long-term costs and survival is challenging, a consistent and valid approach to extrapolating short-term outcomes would be valuable.
  
  
  METHODS
  We developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model, a Web-based simulation tool designed to integrate data on demographic, clinical, and laboratory characteristics; use of evidence-based medications; and costs to generate predicted outcomes. Survival projections are based on a modified Seattle Heart Failure Model. Projections of resource use and quality of life are modeled using relationships with time-varying Seattle Heart Failure Model scores. The model can be used to evaluate parallel-group and single-cohort study designs and hypothetical programs. Simulations consist of 10,000 pairs of virtual cohorts used to generate estimates of resource use, costs, survival, and incremental cost-effectiveness ratios from user inputs.
  
  
  RESULTS
  The model demonstrated acceptable internal and external validity in replicating resource use, costs, and survival estimates from 3 clinical trials. Simulations to evaluate the cost-effectiveness of heart failure disease management programs across 3 scenarios demonstrate how the model can be used to design a program in which short-term improvements in functioning and use of evidence-based treatments are sufficient to demonstrate good long-term value to the health care system.
  
  
  CONCLUSIONS
  The Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model provides researchers and providers with a tool for conducting long-term cost-effectiveness analyses of disease management programs in heart failure.
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC. Electronic address: shelby.reed@duke.edu.
authors.forename: Shelby D
authors.initials: SD
authors.lastname: Reed
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Neilson
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Matthew
authors.initials: M
authors.lastname: Gardner
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom.
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Briggs
authors.affiliation: Division of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Polsky
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC.
authors.forename: Felicia L
authors.initials: FL
authors.lastname: Graham
authors.affiliation: Duke University School of Nursing, Durham, NC.
authors.forename: Margaret T
authors.initials: MT
authors.lastname: Bowers
authors.affiliation: Catawba Valley Cardiology, Conover, NC.
authors.forename: Sara C
authors.initials: SC
authors.lastname: Paul
authors.affiliation: Duke University School of Nursing, Durham, NC.
authors.forename: Bradi B
authors.initials: BB
authors.lastname: Granger
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC; Department of Medicine, Duke University School of Medicine, Durham, NC.
authors.forename: Kevin A
authors.initials: KA
authors.lastname: Schulman
authors.affiliation: Department of Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Whellan
authors.affiliation: University of Pennsylvania School of Nursing, Philadelphia, PA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
authors.affiliation: University of Washington, Seattle, WA.
authors.forename: Wayne C
authors.initials: WC
authors.lastname: Levy
mesh_terms: D003362:Cost-Benefit Analysis; D019468:Disease Management; D006333:Heart Failure / Q000191:economics* / Q000628:therapy*; D006801:Humans; D020407:Internet; D018803:Models, Economic; D011788:Quality of Life