Cost-effectiveness results from the US Carvedilol Heart Failure Trials Program

OBJECTIVE: To evaluate the cost-effectiveness of carvedilol, a beta -blocke r that is approved for use in the US for the treatment of heart failure, ba sed on data from Phase III clinical trials. METHODS: We conducted an economic evaluation alongside the US Carvedilol He art Failure Trials Program, which consisted of four concurrent, randomized, double-blind, placebo-controlled clinical trials; the mean duration of fol low-up across these four trials was 6.5 months (the program was terminated prematurely based on a finding of a 65% mortality benefit). Using data from these trials, we examined the cost-effectiveness of carvedilol in terms of the estimated cost per death averted among patients randomized to such the rapy versus those receiving placebo. Attention was focused on the cost of c arvedilol therapy plus the cost of cardiovascular-related inpatient care. C osts of care were estimated by combining information on healthcare utilizat ion from the clinical trials with secondary sources of cost data. RESULTS: Patients randomized to receive carvedilol had lower mean : : SID e stimated costs of cardiovascular-related inpatient care over 6.5 months com pared with those receiving placebo ($1912 +/- $7595 vs. $4463 +/- $20 565, respectively). As mortality also was lower among carvedilol patients, the e stimated cost per death averted was negative. The probability that carvedil ol would both increase survival and decrease costs of cardiovascular-relate d care over a 6.5-month period was estimated to be 0.98, CONCLUSIONS: Data from the US Carvedilol Heart Failure Trials Program indic ate that carvedilol reduces-mortality in patients with heart failure; our s tudy suggests that it also maybe cost-saving over a period of approximately six months.