Objective: To do a cost benefit analysis comparing standard therapy alone vs. standard therapy plus beta-blockers in the chronic treatment of congestive heart failure. Study Design: Economic evaluation using cost benefit analysis Materials &
Methods: A meta-analysis of double-blind, placebo controlled, randomized trials was the basis for the mortality & morbidity values used in this study. Direct and indirect costs for patients on standard congestive heart failure therapy (diuretic, ACE inhibitor & digoxin) were compared with direct & indirect costs for patients on standard plus beta-blocker therapy. A cohort of 10,000 heart failure patients aged 55 years old was used for the calculations. Results were projected for 11 years, assuming an average Filipino life span of 66 years. Sensitivity and incremental analysis were done by varying mortality rates according to 95% C.I. from the meta-analysis & varying discount rates at 3, 5 & 8%.
Results: Using a mortality rate of 7.5% in patients on standard plus beta-blocker therapy in comparison with the mortality rate of 11.9% for standard therapy, net savings amounted to P 178.3 million using a discount rate of 5%. Sensitivity analysis using a high mortality rate of 10.5% showed savings of P59.3 million while the lowest mortality of 6.3% showed net savings of P226.1 million. Results consistently showed cost benefit even when discount rates were varied from 3-8%.
Conclusion: The use of beta-blockers as adjunctive therapy in the chronic treatment of congestive heart failure is more cost-beneficial than the use of standard therapy alone.