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在多尼亚心力衰竭登记处的一组患者中,使用沙库巴曲缬沙坦降低住院费用。

Hospitalization cost reduction with sacubitril-valsartan implementation in a cohort of patients from the Daunia Heart Failure Registry.

作者信息

Correale Michele, Monaco Ilenia, Ferraretti Armando, Tricarico Lucia, Padovano Giuseppina, Formica Ennio Sascia, Tozzi Valeria, Grazioli Davide, Di Biase Matteo, Brunetti Natale Daniele

机构信息

Department of Medical & Surgical Sciences, University of Foggia, Italy.

Cardio-Thoracic Department, Ospedali Riuniti University Hospital, Foggia, Italy.

出版信息

Int J Cardiol Heart Vasc. 2019 Jan 11;22:102-104. doi: 10.1016/j.ijcha.2018.12.009. eCollection 2019 Mar.

Abstract

INTRODUCTION

Aim of this study was to assess the impact of the introduction of new class of drugs (ARNI: angiotensin receptor-neprilysin inhibitor) on hospital related costs in a real world cohort of patients with chronic heart failure (CHF).

METHODS

Seventy-three consecutive patients with CHF and systolic dysfunction eligible for the treatment with ARNIs from the Daunia Heart Failure Registry were enrolled. Incidence of hospitalizations before and after treatment with ARNI, costs for drug and hospitalization for HF were recorded, indexed per year and compared.

RESULTS

Indexed mean number of hospitalizations per year was 0.93 ± 1.70 before and 0.19 ± 0.70 after introduction of ARNI ( < 0.001, -80%), 2.26 ± 1.95 before and 0.38 ± 1.2 after ARNI in the subgroup of patients with at least one hospitalization for HF in the year before treatment with ARNI ( < 0.001, -83%).Mean indexed cost for hospitalization was 2067 ± 3715 euros before and 1847 ± 1549 after ARNI (p n.s., -11%); in the subgroup with at least one hospitalization for HF 5175 ± 4345 before and 2311 ± 2308 after ARNI (p < 0.001, -55%). Cost reduction increased with the number of indexed hospitalization per year before ARNI from 11% to 66%.

CONCLUSION

In a real world scenario, treatment with ARNI is associated with lower indexed rates of hospitalizations and hospitalization related costs. Cost reduction increases with at least one indexed hospitalization for heart failure before treatment with ARNI.

摘要

引言

本研究的目的是评估新型药物(ARNI:血管紧张素受体脑啡肽酶抑制剂)的引入对慢性心力衰竭(CHF)真实世界队列患者的医院相关费用的影响。

方法

从多尼亚心力衰竭登记处连续纳入73例符合ARNI治疗条件的CHF和收缩功能障碍患者。记录ARNI治疗前后的住院发生率、药物费用和心力衰竭住院费用,按年进行索引并比较。

结果

引入ARNI前每年的平均索引住院次数为0.93±1.70,引入后为0.19±0.70(<0.001,-80%);在ARNI治疗前一年至少有一次心力衰竭住院的患者亚组中,引入ARNI前为2.26±1.95,引入后为0.38±1.2(<0.001,-83%)。住院的平均索引费用在ARNI治疗前为2067±3715欧元,治疗后为1847±1549欧元(p无统计学意义,-11%);在至少有一次心力衰竭住院的亚组中,ARNI治疗前为5175±4345欧元,治疗后为2311±2308欧元(p<0.001,-55%)。成本降低随着ARNI治疗前每年索引住院次数的增加从11%增至66%。

结论

在真实世界中,ARNI治疗与较低的索引住院率和住院相关费用相关。在ARNI治疗前至少有一次心力衰竭索引住院的情况下,成本降低幅度更大。

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