HEART-FAILURE - A DECISION-ANALYTIC ANALYSIS OF NEW-ZEALAND DATA USING THE PUBLISHED RESULTS OF THE SOLVD TREATMENT TRIAL

This study sought to evaluate the changes in direct medical costs and life-years gained or lost by adding enalapril to conventional treatmen t (digoxin and diuretics) for heart failure (HF). The published result s of the Studies of Left Ventricular Dysfunction (SOLVD) Treatment Tri al, and a decision analytical model developed by the University of Pen nsylvania, were used in combination with New Zealand data to undertake the evaluation. All costs were measured in 1993 New Zealand dollars ( $NZ) [$NZ1 = $US0.5509, September 1993]. Potential net cost savings pe r patient treated over a 4-year period were $NZ652 together with an ad ditional 2 months of life gained. If these individual potential cost s avings are extended to the New Zealand population who have HF (but are at present not receiving an ACE inhibitor) then $NZ6 517 000 in disco unted health sector costs could be avoided. The model was sensitive to changes in the price of enalapril, to estimates of the population wit h HE the percentage of the population with HF treated with enalapril, and to hospital unit costs for nonfatal cases of HE The study demonstr ated that the addition of enalapril to the conventional treatment of H F was cost effective when compared with conventional medical therapy a lone.