Cost-effectiveness analysis of long-term moderate exercise training in chronic heart failure

The purpose of this study is to perform a cost-effectiveness analysis of lo ng-term moderate exercise training (ET) in patients with stable chronic hea rt failure. In particular, the study focuses on the survival analysis and c ost savings from the reduction in the hospitalization rate in the exercise group. In the past 10 years, ET has been shown to be beneficial for patient s with stable class II and III heart failure in many randomized clinical tr ials. However, the cost-effectiveness of a long-term ET program has not bee n addressed for outcomes related to morbidity/mortality end points or healt h care utilization. We examined the cost-effectiveness of a 14-month longte rm training in patients with stable chronic heart failure. The estimated in crement cast for the training group, $3,227/patient, was calculated by subt racting the averted hospitalization cost, $1,336/patient, from the cost of ET and wage last due to ET, estimated at $4,563/patient. For patients recei ving ET, the estimated increment in life expectancy was 1.82 years/person i n a time period of 15.5 years, compared with patients in the control group. The cost-effectiveness ratio for long-term ET in patients with stable hear t failure was thus determined at $1,773/life-year saved, at a 3% discount r ate. Long-term ET in patients with stable chronic heart failure is cost-eff ective and prolongs survival by on additional 1.82 years at a low cost of $ 1,773 per/life-year saved. (C) 2001 by Excerpta Medico, Inc.