Glick H, Cook J, Kinosian B, Pitt B, Bourassa M G, Pouleur H, Gerth W
Division of General Internal Medicine, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, USA.
J Card Fail. 1995 Dec;1(5):371-80. doi: 10.1016/s1071-9164(05)80006-5.
The clinical results of the Studies of Left Ventricular Dysfunction (SOLVD) Treatment Trial have been published previously, but no evaluation of cost-effectiveness based on the primary data has been reported. The authors used a decision analytic model based on primary data from SOLVD to estimate years of survival (overall, by New York Heart Association Class, and quality-adjusted) and to estimate costs of nonfatal hospitalizations, ambulatory care, therapy with enalapril, and deaths. Clinical and resource utilization data were derived from participants in SOLVD, and cost data were derived from the United States. Therapy with enalapril during the approximate 48-month follow-up period in SOLVD resulted in a gain of 0.16 year of life and savings of dollars 718. During the patient's lifetime, a survival benefit of 0.40 year, a cost per year of life saved of dollars 80, and a cost per quality-adjusted life year of dollars 115 with the use of enalapril were projected. The results indicated a net savings and gain in life expectancy during the SOLVD treatment trial. The lifetime projection suggests that therapy with angiotensin-converting enzyme inhibitors, such as enalapril, is extremely attractive when compared with many commonly used interventions in patients with cardiovascular disease or heart failure.
左心室功能障碍研究（SOLVD）治疗试验的临床结果此前已经发表，但尚未有基于原始数据的成本效益评估报告。作者使用了一个基于SOLVD原始数据的决策分析模型，来估计生存年数（总体、按纽约心脏协会分级以及质量调整后的），并估计非致命性住院、门诊护理、依那普利治疗以及死亡的成本。临床和资源利用数据来自SOLVD的参与者，成本数据来自美国。在SOLVD约48个月的随访期内，依那普利治疗使寿命延长了0.16年，并节省了718美元。预计在患者的一生中，使用依那普利可带来0.40年的生存获益，每挽救一年生命的成本为80美元，每质量调整生命年的成本为115美元。结果表明，在SOLVD治疗试验期间有净节省和预期寿命的增加。终生预测表明，与心血管疾病或心力衰竭患者常用的许多干预措施相比，使用依那普利等血管紧张素转换酶抑制剂进行治疗极具吸引力。
