Scott W G, Scott H M
Pharmacoeconomics. 1996 Feb;9(2):156-67. doi: 10.2165/00019053-199609020-00007.
This study sought to evaluate the changes in direct medical costs and life-years gained or lost by adding enalapril to conventional treatment (digoxin and diuretics) for heart failure (HF). The published results of the Studies of Left Ventricular Dysfunction (SOLVD) Treatment Trial, and a decision analytical model developed by the University of Pennsylvania, 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 per patient treated over a 4-year period were $NZ652 together with an additional 2 months of life gained. If these individual potential cost savings are extended to the New Zealand population who have HF (but are at present not receiving an ACE inhibitor) then $NZ6 517 000 in discounted health sector costs could be avoided. The model was sensitive to changes in the price of enalapril, to estimates of the population with HF, the percentage of the population with HF treated with enalapril, and to hospital unit costs for nonfatal cases of HF. The study demonstrated that the addition of enalapril to the conventional treatment of HF was cost effective when compared with conventional medical therapy alone.
本研究旨在评估在心力衰竭（HF）的常规治疗（地高辛和利尿剂）中加用依那普利后直接医疗费用的变化以及获得或损失的生命年数。左心室功能障碍研究（SOLVD）治疗试验已发表的结果，以及宾夕法尼亚大学开发的决策分析模型，与新西兰的数据相结合用于进行评估。所有费用均以1993年新西兰元（$NZ）计量（$NZ1 = $US0.5509，1993年9月）。在4年期间，每位接受治疗的患者潜在的净成本节约为$NZ652，同时还可多获得2个月的生命。如果将这些个体潜在的成本节约推广到新西兰患有心力衰竭（但目前未接受血管紧张素转换酶抑制剂治疗）的人群，那么在卫生部门的成本贴现后可避免$NZ6 517 000。该模型对依那普利价格的变化、心力衰竭患者人数的估计、接受依那普利治疗的心力衰竭患者百分比以及心力衰竭非致命病例的医院单位成本敏感。该研究表明，与单独的常规药物治疗相比，在心力衰竭的常规治疗中加用依那普利具有成本效益。
