COST-EFFECTIVENESS OF RAMIPRIL THERAPY FOR PATIENTS WITH CLINICAL-EVIDENCE OF HEART-FAILURE AFTER ACUTE MYOCARDIAL-INFARCTION

The incremental cost-effectiveness of ramipril treatment compared with conventional treatment of patients with clinical evidence of heart fa ilure after acute myocardial infarction was estimated for the UK. Effe ctiveness was based on differential survival and defined as life-years gained using original patient data from the Acute Infarction Ramipril Efficacy Study (AIRE Study). The major cost identified for the ramipr il treatment strategy was the cost of the drug, which was offset by a reduction in cost from lower hospitalisation rates. These treatment co sts were estimated from the prescription of ramipril and the hospitali sation rates in the AIRE Study and secondary sources. Cost-effectivene ss, in terms of costs required for each life-year gained, was calculat ed over three treatment periods (1, 2, and 3.8 years). Future costs an d effectiveness were discounted at 6% per year. The cost-effectiveness from treatment with ramipril for heart failure after acute myocardial infarction ranged from pound 148 to pound 426 per life-year gained, d epending on the duration of treatment. Ramipril treatment offers a sub stantial survival benefit to patients, Its cost-effectiveness compares favourably with that of chronic heart failure treatment and other com mon medical therapies.