A COST-MINIMIZATION OF HEART-FAILURE THERAPY WITH BISOPROLOL IN THE FRENCH SETTING - AN ANALYSIS FROM CIBIS TRIAL DATA

Beta-blocker-induced benefit in heart failure is under intense evaluat ion. Several large-scale mortality trials are currently being performe d, with CIBIS II evaluating bisoprolol. The economic impact of beta-bl ocker therapy in heart failure has not been previously determined. The present study is a cost-effectiveness evaluation of bisoprolol treatm ent based on CIBIS I data. It considers direct costs, that is, the bis oprolol medication cost and the cost of hospitalization related to hea rt failure and its complications. Hospitalization costs were calculate d from the French system of classification (PMSI), which provides cost s according to homogeneous groups of patients (GHM). The cost differen ce between bisoprolol and placebo in the entire CIBIS population and t he trial duration result from an increase in cost caused by bisoprolol treatment (+ 2018 Frs/patient) and a decrease in cost related to redu ced hospitalization (6349 Frs/patient). A total savings per patient of about 4330 Frs was produced by bisoprolol. Cost reduction is still mo re pronounced in patients not having a history of myocardial infarctio n. We conclude that heart failure therapy with bisoprolol lowers medic al healthcare costs, mainly due to the reduced rate of hospital admiss ions for heart failure.