Levy P, Lechat P, Leizorovicz A, Levy E
LEGOS, Université Paris-Dauphine, France.
Cardiovasc Drugs Ther. 1998 Jul;12(3):301-5. doi: 10.1023/a:1007773901631.
Beta-blocker-induced benefit in heart failure is under intense evaluation. Several large-scale mortality trials are currently being performed, with CIBIS II evaluating bisoprolol. The economic impact of beta-blocker therapy in heart failure has not been previously determined. The present study is a cost-effectiveness evaluation of bisoprolol treatment based on CIBIS I data. It considers direct costs, that is, the bisoprolol medication cost and the cost of hospitalization related to heart failure and its complications. Hospitalization costs were calculated from the French system of classification (PMSI), which provides costs according to homogeneous groups of patients (GHM). The cost difference between bisoprolol and placebo in the entire CIBIS population and the trial duration result from an increase in cost caused by bisoprolol treatment (+ 2018 Frs/patient) and a decrease in cost related to reduced hospitalization (6349 Frs/patient). A total savings per patient of about 4330 Frs was produced by bisoprolol. Cost reduction is still more pronounced in patients not having a history of myocardial infarction. We conclude that heart failure therapy with bisoprolol lowers medical healthcare costs, mainly due to the reduced rate of hospital admissions for heart failure.
β受体阻滞剂对心力衰竭的益处正在进行深入评估。目前正在开展多项大规模死亡率试验，其中心脏 insufficiency bisoprolol 研究（CIBIS II）正在评估比索洛尔。此前尚未确定β受体阻滞剂治疗心力衰竭的经济影响。本研究基于CIBIS I数据对比索洛尔治疗进行成本效益评估。它考虑了直接成本，即比索洛尔药物成本以及与心力衰竭及其并发症相关的住院费用。住院费用根据法国分类系统（PMSI）计算，该系统根据同类患者组（GHM）提供费用。在整个CIBIS人群中，比索洛尔和安慰剂之间的成本差异以及试验持续时间是由比索洛尔治疗导致的成本增加（每位患者增加2018法郎）和与住院减少相关的成本降低（每位患者6349法郎）造成的。比索洛尔使每位患者总共节省约4330法郎。在没有心肌梗死病史的患者中，成本降低更为明显。我们得出结论，比索洛尔治疗心力衰竭可降低医疗保健成本，主要是由于心力衰竭住院率降低。
